Dr ALM’s Medicolegal Series Part 1 - Supreme Court Judgement - Informed Consent

Abstract

Abstract 44 year old unmarried female attended a Gynaecologist clinic for excess bleeding per vaginum . Patient was advised to undergo Diagnostic Laparoscopy and consent was obtained for Laparoscopy/Laparptomy if needed. When Laparoscopy was performed under General Anaesthesia it was found that the patient was found to have endometriosis and while the patient was under anaesthesia ,the assistant surgeon obtained consent from the mother of the patient for Hysterectomy with Bilateral salphingo oophorectomy. The patient sued the Gynaecologist for removing her uterus with ovaries which has led to premature menopause and Hormone Replacement Therapy. The National Consumer Council dismissed the appeal and the patient appealed in Supreme Court. Honourable Supreme Court held that in Medical Law, where a surgeon is consulted by a patient, and consent of the patient is taken for diagnostic procedure/surgery, such consent cannot be considered as authorisation or permission to perform therapeutic surgery either conservative or radical (except in life threatening or emergent situations). Similarly where the consent by the patient is for a particular operative surgery, it cannot be treated as consent for an unauthorized additional procedure involving removal of an organ, only on the ground that such removal is beneficial to the patient or is likely to prevent some danger developing in future. Honourable Supreme Court allowed this appeal and set aside the order of the Commission and allow the appellant’s claim in part. If the respondent has already received the bill amount or any part thereof from the appellant (either by executing the decree said to have been obtained by her or otherwise), the respondent shall refund the same to the appellant with interest at the rate of 10% per annum from the date of payment till the date of re-payment. The Respondent shall pay to the appellant a sum of Rs.25, 000/- as compensation with interest thereon at the rate of 10% per annum from 19.11.2003 (the date of the order of Commission) till date of payment. The appellant will also be entitled to costs of Rs.5, 000 from the respondent.