A recent medical malpractice lawsuit stemming from a surgery performed at West Jefferson Medical Center defines your right to make an informed decision about the course of treatment you wish to take. The patient in this case suffered from heavy menstrual bleeding primarily resulting from fibrin tumors in her uterus. A General Practitioner previously prescribed the patient Depo-Provera, a steroid injection that alters hormone levels associated with the menstrual cycle. The prescription had little effect treating the symptoms and caused the patient to gain over twenty-five pounds. Unhappy with the treatment, the patient consulted her OBGYN, who recommended a hysterectomy to completely remove the tumored uterus. The OBGYN recommended the operation two more times before the patient consented to the surgery, over two years after the initial consultation. Unfortunately for everyone involved, the patient’s bowel was perforated during the surgery. The patient subsequently sued, claiming that the OBGYN failed to inform her of all the potential treatment options before the operation and that she would never have gone through with the operation had she known of less risky treatments.
The doctrine of informed consent protects a patient’s right to choose which therapeutic or surgical treatment to pursue by requiring doctors to provide the patient with the information needed for that decision. Exactly what information the doctor must disclose is the primary issue in this case. The patient contends that all information pertaining to the associated risk and any potential treatment options should be disclosed while the doctors believe they must disclose only those risk and options that are feasible or appropriate given the patient’s unique circumstances. The law favors the doctors. In 2013, the Supreme Court of Louisiana, when faced with a similar question, decided that doctors must provide sufficient information and disclose reasonable alternatives rather than all information or all alternatives. See Snider v. La. Med. Mut. Ins. Co., 130 So. 3d 922 (La. 2013). What constitutes “sufficient” information and “reasonable” alternatives changes depending largely on the medical history of the patient. The doctor is given some discretion determining what is reasonable and sufficient, but he or she must adhere to the standard of the profession. The doctor must do what most other doctors would have done in the same situation.
In this case, the OBGYN told the patient that her options were limited to a hysterectomy, a mastectomy, or continued injections of Depo-Provera. She also told the patient that, as with any hysterectomy, there was a risk of bowel perforation during the surgery. The patient signed an informed consent form stating that she was aware of the options and the risks; however, a couple of months after the surgery, and after the perforated bowel, the patient found an article published by the American Congress of Obstetricians and Gynecologists (ACOG article) that listed options beyond those disclosed by OBGYN. One option in particular, Lupron, was an injection that has been shown to reduce the size of fibrin tumors. In her suit, the patient specifically claims that had she known of Lupron, she would not have needed nor consented to a hysterectomy and that the OBGYN was liable for her injury for failing to inform her of the option.