Lancaster Physician Fall 2017 - 4

L A N C A S T E R M E D I C A L S O C I E T Y.O R G

President's Message

T
David Simons, DO,
FAOCA
President, LCCMS

he Pennsylvania Supreme Court
published a landmark ruling on
June 20, 2017 explaining a physician's duty to provide sufficient
information to a patient directly to obtain
legally valid informed consent. In Shinal v.
Toms, 162A.3d 429 (PA 2017), the Supreme
Court held that a physician's duty to provide
information to a patient to obtain informed
consent is non-delegable. A physician cannot
rely upon a qualified assistant (including a nurse
practitioner or physician assistant) to disclose the
information required to gain informed consent.
At first blush, this ruling appears to really not
change much of anything that we physicians
want for our patients. However, many of us
do rely on others to inform patients of the
risks, benefits, and alternatives for the invasive
procedures we perform.
Under current Pennsylvania law, a physician owes a duty to a patient to obtain the
informed consent prior to conducting the
following five procedures:
* Performing surgery, including anesthesia
administration
* Administering radiation or chemotherapy
* Administering a blood transfusion
* Inserting a surgical device or appliance
* Administering experimental medications
or using a device or medication in an
experimental manner
Interestingly, to succeed in a claim for lack
of informed consent the patient need only
prove that:

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procedures, however, every physician and
practice must now evaluate the impact this
ruling has on their current informed consent
policy and the potential disruption to their
ability to offer team-based care to their
patients. PAMED recommends the following:
* Review practice policies and procedures
with independent legal counsel.
* Review and, if necessary, revise medical
staff policies and procedures.
* Participate in development and
implementation of hospital informed
consent policies.
* Ensure that all informed consent forms
are properly executed and filed.
Other helpful strategies may include
procedure-specific consents, and signature
witness verifications to confirm that physician
informed consent has been obtained prior to
any procedure.
This ruling is currently being challenged.
PAMED, with support from the AMA, filed
an amicus brief for the Superior Court's holding
that information provided by a qualified assistant can be used to obtain a patient's informed
consent for surgery.
An amicus brief is aimed at protecting the
interests of individuals or organizations that are
absent for the proceedings but whose interests
are potentially jeopardized by the litigation.
Amicus briefs are powerful and effective tools
in developing public policy-including public
health policy.

1) The physician failed to disclose a relevant
Stay tuned for further updates on this and
risk or alternative before obtaining the other important matters impacting our daily
patient's consent for a covered procedure, and  professional activities and responsibilities. Rest
assured that the LCCMS and PAMED are
2) The undisclosed information would have making every effort to continue to advocate for
been a substantial factor in the patients' all physicians in our continued quest to provide
decision whether to undergo the procedure. excellent care to our patients.
Now, as a result of the recent Supreme
Court's decision, the patient may also succeed
in a lack of informed consent claim if the
physician did not personally relay the information to the patient. All of us recognize the
importance of obtaining informed consent
from patients prior to performing invasive

LANCASTER

4

PHYSICIAN

As always, thank you for your membership
and your continued support of the LCCMS.
Sincerely,

DJS


http://www.lancastermedicalsociety.org

Table of Contents for the Digital Edition of Lancaster Physician Fall 2017

Lancaster Physician Fall 2017 - 1
Lancaster Physician Fall 2017 - 2
Lancaster Physician Fall 2017 - 3
Lancaster Physician Fall 2017 - 4
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