Analyzing the Case of Hookey vs Paterno - Essay Example

? Case Study- Hookey v Paterno (2009) According to Hookey v Paterno (2009) VSCA 48, Dr. Stephen Hockey lodged an appeal, challenging a court ruling requiring him to compensate Daniela Peterno her $1,057,833 for a surgery gone bad. After consulting the doctor in 1997 in relation to an extraordinary class II malocclusion she suffered, Dr Hockey had Mrs Paterno undergo corrective surgery. Her upper jaws and lower jaws were not properly aligned, leading to an abnormal bite pattern. She suffered from a severe overbite and related problems that caused her difficulty in chewing. The high court confirmed that she had three corrective surgeries that left her in great pain, incapable of being cured by further surgery. Based on her advanced age and smoking habits, the court established that chances that the surgery would lead to permanent nerve damage were high. Mrs Paterno suffered from nerve damage which the judges identified as a known complication of the surgery. The court found out that Mr. Hookey did not sufficiently inform Mrs Paterno of a rare possibility that the dental and facial operation could result to endless pain. According to the judges, Dr Hookey negligently advised Mrs Paterno to undergo surgery, failing to warn her in a manner she understood best of the risks involved. On the other hand, Dr. Hookey said that he warned Mrs Paterno that in 95% of cases the trigeminal nerve is injured, and that the plaintiff would expect to feel numb in her teeth, lip and chin after the operation. The court ruled that Mr. Hookey ought to have informed Mrs Paterno of very rare complications of non-union of the jaw or that the plaintiff may suffer from continuous pain as an unusual occurrence of nerve damage. The doctor had the duty to give her sufficient details in the simplest way so she would understand the risks involved. In their ruling, the judges referred to Santow AJA Johnson v Biggs case stating that the doctor was obliged to warn the patient of any post surgical effects. Additionally, the judges found that the doctor was obliged to warn the patient of the risks of going ahead with the surgery as well as the risks of failing to undergo the surgery, as long as the patient’s health was affected either way. The doctor needed to care for the patient by clearly laying out the risks involved in order to get the patient’s informed consent. The appellant was required to outline the possible consequences resulting from the treatment including numbness and a less likely outcome of continuous pain. According to Freckelton (1999) Dr. Hookey breached his duty of care by failing to adequately inform the patient of postsurgical risks. The judges emphasized the duty of care and its legal impact. Referring to Rogers v Whitaker (1992) HCA 58 the High Court stressed the legal duty to adequately inform patients of dire surgical consequences related to prescribed treatment. This duty complements the doctor’s privilege to perform corrective surgery on the patient. Procedures involved in treatment must be clearly explained to patients to enable them give informed consent on the treatment they receive. Concise information enables the patient to be more comfortable and prepares the patient for the anticipated experience. For a risk to be considered material, it needs to have great repercussions. Also, the chances of it actually happening need to be high and alternative treatments need to be present. Duty of care is the doctor’s obligation to ensure reasonable care when performing his duties (Ketley 2005, 656). Dr. Hookey was found guilty of negligence based on the following conditions: (1) he owed Mrs Paterno duty of care, (2) this duty of care was breached and (3) Mrs Paterno suffered an injury as a direct consequence of the breach of duty of care (Anderson 2006, 156). Dr Hooker was therefore found guilty of negligence as evidence indicated that he failed to sufficiently inform Daniela of the grave consequences related to the operation she underwent. This case emphasized the need to set minimum standards in the delivery of health services. Medical practitioners are vulnerable to be found legally liable for negligence. The law of negligence does not leave room for errors. It highlights the ‘duty of disclosure’ and the need to inform patients of all ‘material risks’ associated with a procedure (Freckelton 1999). In this case, Dr. Hookey should have identified Mrs Paterno’s concern about the risks of continuous pain following the operation. A warning about the untreatable pain was very significant to the plaintiff. The law required the doctor to uphold his duty of care and safeguard the patient’s best interests. McKechnie and Kohn (1999, 71) point out that care is affective and effective; and may be conceptualized as a duty, as a responsibility, as a professional task, as a labour of love. This case reinforced the recognition that people have the right to decide for themselves whether or not they will undergo medical treatment. It highlights the patient’s right of autonomy despite the fact that withdrawal of treatment would be life threatening. Autonomy is the capacity to think, decide and freely act on the basis of such thought (Singleton and McLaren 1995, 107). There is need to distinguish between diagnosis and treatment, and doctors need to understand the importance of informing patients of risks involved in their prescribed treatment. Mrs. Paterno confessed that had she been adequately informed of the risks involved in her operation, she would have opted out. She would have withdrawn from the surgery and endured minor inconveniences rather than risk the possibility of endless pain. This case underscores medical ethics of beneficence, non-maleficence, justice and respect for patient autonomy; that are fundamental in the delivery of medical services (Heifetz, 1996, 102). According to Kuczewski and Pinkus (1 999), competence, decision making capacity and ethical aspects go hand in hand in providing medical care to patients. Ethical awareness can minimize our false starts and backtracking (DePender and Ikeda-Chandlere 1990, 89). The Hookey v Paterno’s case has influenced all aspects of the health care field, with Medical Imaging being no exception. It highlighted the duty of health care professionals to fully inform patients of all possible consequences arising from surgical operations, regardless of how rare they are. This view enables patients to be sufficiently informed of all the risks and complications of their proposed treatment, enabling them to be more knowledgeable of their situation and make better decisions about what is best for them. Doctors must observe duty of care and discuss the material risks and complications involved in treatments. The case highlights the essence of disclosing all information to patients regarding a treatment to enable them give intelligible consent, and to avoid legal liability on the doctor’s part. REFERENCES Alderson, P. 2006. Legal dictionary for Australians. 2nd ed. North Ryde, NSW: McGraw Hill Australia Pty Ltd. DePender W., and Ikeda-Chandlere W. 1990. Clinical Ethics: An Invitation to Healing Professionals. Westport: Praeger. Freckelton, I. 1999. The new duty to warn. Alternative Law Journal. 24(1) http://www.austlii.edu.au/au/journals/AltLJ/1999/4.html (Accessed May 27, 2008). Heifetz, M. 1996. Ethics in Medicine. New York: Prometheus Books. Ketley, H. 2005. The WA law handbook. 5th ed. East Victoria Park, WA: Sussex Street Community Law Services, Inc. Kuczewski M. Pinkus R. 1999. An Ethics Casebook for Hospitals: Practical Approaches to Everyday Cases. Washington: Georgetown University Press. Kohn T,. and McKechnie R. 1999. Extending the Boundaries of Care: Medical Ethics and Caring Practices. New York: Berg. Singleton J. and McLaren S. 1995. Ethical Foundations of Health Care: Responsibilities in Decision Making. St. Louis: Mosby. LEGAL AUTHORITY Hookey v Paterno (2009) VSCA 48, www.lexisnexis.com/community/.../2009/03/.../hookey-v-paterno.asp (Accessed May 3, 2012) Rogers v Whitaker [1992] 175 CLR 479. High Court of Australia http://www.austlii.edu.au/cgi-bin/sinodisp/au/cases/cth/high_ct/175clr479.html?query=%20Rogers%20v%20Whitaker (Accessed May 2, 2012). Read More