Comments on: The consent wasn’t informed enough http://www.kevinmd.com/blog/2006/07/consent-wasnt-informed-enough.html Tue, 14 Feb 2012 17:18:00 +0000 hourly 1 By: Gary Levinhttp://www.kevinmd.com/blog/2006/07/consent-wasnt-informed-enough.html#comment-109909 Gary Levin Thu, 20 Aug 2009 14:41:02 +0000 http://clients.emmense.com/kevinmd/2006/07/the-consent-wasnt-informed-enough.html#comment-109909 In the US Army a mandatory 'briefing' is held for 30 soldiers at a time (for Lasik, or PRK) It is well scripted, and planned. Ths included anatomical drawing and a lengthy discussion of the theory and practical application(s) of refractive surgery. It is as detailed as showing pictures of the medication bottles with the instructions for taking them before and after. There is a question and answer period, and usually questions are asked and answered that are often not asked b y others in the audience. One question provides an answer for all who attend. At the end a quiz is given which they must pass.It is a very efficient method, and provides a uniform consent process for all concerned..... In the US Army a mandatory ‘briefing’ is held for 30 soldiers at a time (for Lasik, or PRK) It is well scripted, and planned. Ths included anatomical drawing and a lengthy discussion of the theory and practical application(s) of refractive surgery. It is as detailed as showing pictures of the medication bottles with the instructions for taking them before and after. There is a question and answer period, and usually questions are asked and answered that are often not asked b y others in the audience. One question provides an answer for all who attend.
At the end a quiz is given which they must pass.

It is a very efficient method, and provides a uniform consent process for all concerned…..

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/07/consent-wasnt-informed-enough.html#comment-65215 Anonymous Thu, 20 Jul 2006 23:55:00 +0000 http://clients.emmense.com/kevinmd/2006/07/the-consent-wasnt-informed-enough.html#comment-65215 What and how much informed consent is enough? I had always given the usual and customary potential complications in any procedure and its percentages to the patient. Now do I have to give a 20 page dissertation? Besides which, most of my patient population doesn't have much past a high school education... What and how much informed consent is enough? I had always given the usual and customary potential complications in any procedure and its percentages to the patient. Now do I have to give a 20 page dissertation? Besides which, most of my patient population doesn’t have much past a high school education…

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/07/consent-wasnt-informed-enough.html#comment-65203 Anonymous Thu, 20 Jul 2006 21:39:00 +0000 http://clients.emmense.com/kevinmd/2006/07/the-consent-wasnt-informed-enough.html#comment-65203 How long until the public library closes and the crazies go back home? How long until the public library closes and the crazies go back home?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/07/consent-wasnt-informed-enough.html#comment-65198 Anonymous Thu, 20 Jul 2006 21:18:00 +0000 http://clients.emmense.com/kevinmd/2006/07/the-consent-wasnt-informed-enough.html#comment-65198 "You're not the brightest bulb either - at least 30% goes to the sodomites. "<br/><br/>ONLY 30% IF THE PLAINTIFF IS LUCKY; IF YOU LIVE IN NEW YORK THE SODOMITE MAY SUE HIS OWN PLAINTIFF TO GET MORE THAN 30%. THEY LEAVE NOTHING BUT THE BONES, THEY'D EAT THE FECES IF THERE WAS ANY MONEY IN IT. “You’re not the brightest bulb either – at least 30% goes to the sodomites. “

ONLY 30% IF THE PLAINTIFF IS LUCKY; IF YOU LIVE IN NEW YORK THE SODOMITE MAY SUE HIS OWN PLAINTIFF TO GET MORE THAN 30%. THEY LEAVE NOTHING BUT THE BONES, THEY’D EAT THE FECES IF THERE WAS ANY MONEY IN IT.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/07/consent-wasnt-informed-enough.html#comment-65189 Anonymous Thu, 20 Jul 2006 19:34:00 +0000 http://clients.emmense.com/kevinmd/2006/07/the-consent-wasnt-informed-enough.html#comment-65189 You're not the brightest bulb either - at least 30% goes to the sodomites. You’re not the brightest bulb either – at least 30% goes to the sodomites.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/07/consent-wasnt-informed-enough.html#comment-65182 Anonymous Thu, 20 Jul 2006 16:28:00 +0000 http://clients.emmense.com/kevinmd/2006/07/the-consent-wasnt-informed-enough.html#comment-65182 " That's 4 million bucks taken away from the Healthcare system and given to the Sodomites."<br/><br/>You're not the brightest bulb, are you? Where do you think this money for "past and future medical bills" goes? ” That’s 4 million bucks taken away from the Healthcare system and given to the Sodomites.”

You’re not the brightest bulb, are you? Where do you think this money for “past and future medical bills” goes?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/07/consent-wasnt-informed-enough.html#comment-65176 Anonymous Thu, 20 Jul 2006 15:05:00 +0000 http://clients.emmense.com/kevinmd/2006/07/the-consent-wasnt-informed-enough.html#comment-65176 "What's your eyesight worth?"<br/><br/>No, what's your eyesight worth? That's 4 million bucks taken away from the Healthcare system and given to the Sodomites. And don't open your Big Fat mouth when you show up urgently at a hospital and they have to transfer you to another state for brain surgery, or hand surgery. “What’s your eyesight worth?”

No, what’s your eyesight worth? That’s 4 million bucks taken away from the Healthcare system and given to the Sodomites. And don’t open your Big Fat mouth when you show up urgently at a hospital and they have to transfer you to another state for brain surgery, or hand surgery.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/07/consent-wasnt-informed-enough.html#comment-65161 Anonymous Thu, 20 Jul 2006 01:33:00 +0000 http://clients.emmense.com/kevinmd/2006/07/the-consent-wasnt-informed-enough.html#comment-65161 "A million for future medical expenses?"<br/><br/>That's probably a simplification, because it likely includes lost wages as well.<br/><br/>" And a million for past pain and suffering? This award is begging to be overturned or reduced."<br/><br/>What's your eyesight worth?<br/><br/>"The one element that is not considered by the courts is whether the informed consent, even if deemed insufficient, mattered."<br/><br/>That's not the only ground the jury found on, and who knows how much weight it was given. I remember living in Dallas and they would have those cattle calls, and if you were an early signee, one of the first $20 or so, you got it cheaper. “A million for future medical expenses?”

That’s probably a simplification, because it likely includes lost wages as well.

” And a million for past pain and suffering? This award is begging to be overturned or reduced.”

What’s your eyesight worth?

“The one element that is not considered by the courts is whether the informed consent, even if deemed insufficient, mattered.”

That’s not the only ground the jury found on, and who knows how much weight it was given. I remember living in Dallas and they would have those cattle calls, and if you were an early signee, one of the first $20 or so, you got it cheaper.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/07/consent-wasnt-informed-enough.html#comment-65160 Anonymous Thu, 20 Jul 2006 01:04:00 +0000 http://clients.emmense.com/kevinmd/2006/07/the-consent-wasnt-informed-enough.html#comment-65160 A million for future medical expenses? She could have a cornea transplant a hundred times over and not spend that. And a million for past pain and suffering? This award is begging to be overturned or reduced.<br/><br/>Forme fruste keratoconus is very difficult to identify with any degree of reliability, even with present technology, which is much better than what was available in 2000, when the surgery was done. As the jury is reported to have rejected the insufficient stromal bed theory (probably because there was chart data to refute it and the argument of over-ablation) the reasoning behind the jury's finding becomes even more tenuous-- almost speculative.<br/><br/>I bet this gets overturned. Even with the little information given, it seems a flawed judgment. A million for future medical expenses? She could have a cornea transplant a hundred times over and not spend that. And a million for past pain and suffering? This award is begging to be overturned or reduced.

Forme fruste keratoconus is very difficult to identify with any degree of reliability, even with present technology, which is much better than what was available in 2000, when the surgery was done. As the jury is reported to have rejected the insufficient stromal bed theory (probably because there was chart data to refute it and the argument of over-ablation) the reasoning behind the jury’s finding becomes even more tenuous– almost speculative.

I bet this gets overturned. Even with the little information given, it seems a flawed judgment.

]]> By: Gasmanhttp://www.kevinmd.com/blog/2006/07/consent-wasnt-informed-enough.html#comment-65156 Gasman Wed, 19 Jul 2006 23:55:00 +0000 http://clients.emmense.com/kevinmd/2006/07/the-consent-wasnt-informed-enough.html#comment-65156 The one element that is not considered by the courts is whether the informed consent, even if deemed insufficient, mattered. That is, is there any reason to believe that the patient would have chosen not to have the Lasik procedure if the consent were somehow more complete than a multipage description. <br/>Sure, she would argue that she would have done otherwise if just some last final small detail were included in the consent, but the jurors would know that prior to a poor outcome, most people would in fact turn a blind eye to most potential hazards enumerated in the informed consent process. Really, for common and purely elective cosmetic procedures like Lasik it would be hard for an average American to state with a straight face that they didn't personally surf numerous web sources until they were satisfied with the risk/benefit ratio, and not merely rely upon the doctor/patient conversation as their only source of information. The one element that is not considered by the courts is whether the informed consent, even if deemed insufficient, mattered. That is, is there any reason to believe that the patient would have chosen not to have the Lasik procedure if the consent were somehow more complete than a multipage description.
Sure, she would argue that she would have done otherwise if just some last final small detail were included in the consent, but the jurors would know that prior to a poor outcome, most people would in fact turn a blind eye to most potential hazards enumerated in the informed consent process. Really, for common and purely elective cosmetic procedures like Lasik it would be hard for an average American to state with a straight face that they didn’t personally surf numerous web sources until they were satisfied with the risk/benefit ratio, and not merely rely upon the doctor/patient conversation as their only source of information.

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