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Unbalanced information to patient leads to major surgery to remove liver cyst (01HDC05619)
Download Unbalanced information to patient leads to major surgery to remove liver cyst (01HDC05619) (PDF 12Kb)
(01HDC05619, 31 July 2002)
Surgeon ~ Private hospital ~
Information about condition and treatment options ~ Liver surgery ~
Rights 4(1), 6(1)(a), 6(1)(b)
A 55-year-old woman complained that a hepatobiliary surgeon at a
private hospital did not correctly assess and diagnose the nature
of a cyst on her liver, and did not offer any satisfactory
alternatives to major surgery.
In many areas of medicine there is no consensus, and judgements
must be made by balancing various aspects of treatment and
associated side effects. An informed decision on the part of the
patient requires balanced and fair information reflecting both
personal experience and published results. In this patient's case,
the vast majority of surgeons would not have contemplated resection
(hepatectomy) as the initial treatment for a simple cyst, and the
patient was entitled to information that fully reflected not only
the individual surgeon's opinion but also the majority opinion
within the field.
The Commissioner held that surgeon did not breach Right 4(1)
because he appropriately assessed the patient's condition and
recognised it as a simple cyst of the liver. However, the surgeon
breached Rights 6(1)(a) and 6(1)(b) as he exaggerated the benefits
of hepatectomy by raising the cancerous potential of the cyst and
overstating the risk of recurrence when all available evidence was
to the contrary. He presented the patient with an unbalanced
explanation of her condition, which supported his own treatment
preference, and failed to provide adequate information about the
alternative of treatment in the public system.
The private hospital was not vicariously liable for the surgeon's
breach of the Code because it could not reasonably have prevented
the omission by the surgeon to provide adequate information in his
area of clinical expertise.
The Commissioner referred the matter to the Director of
Proceedings, who decided not to issue proceedings.
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