To elaborate on sarahw’s comment, “consent” is a defense to the tort/crime of “battery”. A battery being an offensive/harmful touching, the defense of consent occurs most often in medical and sports contexts.

“Informed consent” is a completely different animal, however. Lack of informed consent is neither a tort nor a crime, although informed consent may be required by statute and/or administrative regulations and/or ethics codes.

Both require signatures on pieces of paper written by lawyers. Thus the confusion. That and the shared word, “consent”.

Just in case you were wondering.

We all know this isn’t true.

Hell, half the people don’t even understand the medical procedures they will go through.

Now it seems some folks are expecting uneducated members of the public who don’t necessarily have an understanding of how the medical training system work, to… what? See the words “teaching hospital” somewhere in the building (it’s almost never a part of the hospital name, FWIW) and magically coprehend that there is ___% change a medical student or other rainee will perform ___ procedure, with/without supervision by ___ doctor?

Come on; isn’t this obviously a bit silly? The whole “EVERYONE knows that….” angle only works when, well, everyone DOES know.

And it’s moot here anyway. Everyone knows that hospitals give epidurals to most ptients. What on earth does that have to do with whether a certain patient gets one when she does/does not want it?

But the caveat still remains that when you elect to come to a teaching hospital where the delivery of care integrally relys upon the participation of trainees of various levels of experience (and varying levels of direct supervision) that asking for special treatment, that is attending only, will inevitably lead to delays and other issues forseen as well as unforseen related to receiving non-standard care.

http://www.parkview.com/body.cfm?id=409&oTopID=409&PLinkID=201

In the first section of this document on patient care decisions, there is the following:

“(the patient has the right to) Know of any experimental, research or educational activities that may affect your care or treatment and the right to refuse to take part. “

So, by the hospital’s own standards, which they state are in accordance with Indiana’s laws, the patient in this intubation case had the right to know that a EMT-to-be would be involved in her care. And the patient also had the right to refuse to take part in this educational activity.

Are these hospital statements really meant to be followed, or are they just so much window-dressing, only meant to fool the public into a false sense of security?

Most hospitals include this fact in their patient “bill of rights”. It IS “standard operating procedure.”

FWIW, the issue of “battery” IS one of consent. It is the core of a battery claim.

This woman was severely harmed by an unpermitted touching.

Extraordinary demands should have to bear the additional costs too. That too is only fair.

When a patient shows up to my university hospital it should be quite obvious to all that trainees of various levels of qualification and certification will participate in their care.

If the patient wishes a particular service to alter its routine practices for who does what then the patient should express their wishes. Talking to the surgeon or making notation on the surgical consent is not sufficient notice to alter the pratices of other physicians, such as the anesthesiologist. In this case it is alleged that a written consent was obtained for the anesthesia care specifying who could do what. In the absence of an unforseen emergency there should then be no deviation from the agreed plan.

I always insist that my non-anesthesia residents (emergency medicine, pediatrics, cardiology fellows, critical care fellows etc.) introduce themselves to the patient/family as part of the consent process. The anesthesia resident or fellow always meets the family preoperatively so their presence also is known.

Whenever a family objects to resident physician care I describe the attending/resident care team model again. If they still defer resident care then the case is delayed until I can personally perform things myself. Of course there is a down side they might not have forseen, but when working solo I will routinely start the IV in the child awake rather than do an inhalation induction without anyone available to assist with either the IV or airway.