Medical professionals urged to strengthen consent practices to align with ethical legal trends
Published:Saturday | November 2, 2024 | 12:08 AMAsha Wilks/Gleaner Writer
Dr Peter Glegg, an attorney and former senior surgery resident at the St Ann’s Bay Regional Hospital, is calling on radiologists and other medical professionals to strengthen their consent forms to better protect patients and sustain the ethical use of radiation and nuclear medicine.
This recommendation comes as Jamaican judges are increasingly factoring ethical considerations into their rulings in cases involving patient care.
Speaking on Wednesday at the 31st National Science and Technology Conference, organised by the Scientific Research Council (SRC) and the International Atomic Energy Agency (IAEA), Dr Glegg stressed that more comprehensive consent forms are essential for patient safety and the responsible use of nuclear technology. He argued that establishing safe practices not only protects patients but also safeguards the broader environment.
Dr Glegg, campus legal officer at the University of the West Indies (UWI) and lecturer at the Norman Manley Law School, highlighted the importance of compensation mechanisms in cases involving ionizing radiation, pointing out that such provisions are critical to addressing potential harm to patients. He noted that, as Jamaica moves towards potential future applications of nuclear reactors, these safety measures become increasingly important.
In recent years, Jamaican jurisprudence has evolved to blend legal and ethical issues into a unified approach in the courts. Dr Glegg observed that this shift requires medical professionals to obtain “full consent” from patients, meaning that procedures must be clearly and thoroughly explained before consent is given.
To illustrate his point, Dr Glegg referenced the Octavia Chambers v South East Regional Health Authority case, where the claimant, Chambers, sought medical care for a septic miscarriage. Due to complications, doctors performed a hysterectomy to save her life.
Chambers claimed that no one explained the risk of losing her uterus or the details of a septic miscarriage, and she argued that she did not consent to the hysterectomy. Ultimately, the court ruled in her favour, determining that because she was not informed of all treatment options, her consent was incomplete and therefore invalid.
“What the court said in Octavia Chambers’ case was that because the doctors had not mentioned one possible type of treatment, the consent that was given was not full consent,” Dr Glegg explained.
“She did not have a chance to consider that aspect in making her decision, so the court ruled that the consent was not valid.”
He added that, although the doctors acted to save her life, they were deemed negligent due to the lack of full disclosure.
Dr Glegg further explained the concept of “duty of care”, emphasising that while some patients may refuse care and even consent to life-saving treatment, medical professionals must respect these decisions. He pointed out that, in the context of radiation safety, this duty extends first to the patient, then to the medical and healthcare staff, and finally to the general public.
“Now it is established law that employers owe a duty of care to their employees, ensuring a safe place and system of work,” he said, underscoring the responsibility of healthcare employers to protect their staff when working with radiation.
EVOLVING OF LEGAL PROCEEDINGS
Dr Glegg noted that, in previous court decisions, judges have typically deferred to medical professionals in emergency situations, allowing doctors to make life-saving decisions.
He described a scenario in which a patient arrives at an emergency room in critical condition, necessitating an immediate X-ray or CT scan even if consent cannot be obtained due to unconsciousness or lack of patient information.
However, with legal proceedings evolving, Dr Glegg raised the question, “When you do even a basic X-ray, is it that we don’t need to have consent forms signed?”
Although the answer remains unclear, he pointed to existing practices where departments display signs, such as those warning pregnant women about radiation exposure. In his view, the trend may move towards formal counselling sessions to inform patients about even minimal radiation exposure risks.
To prepare for this shift, Dr Glegg urged healthcare practitioners to provide consent documents that thoroughly outline radiation risks to all relevant parties: patients, their relatives, healthcare providers, and employees working in environments with radioactive materials.
The four-day science and technology conference concluded yesterday at the Jamaica Conference Centre in downtown Kingston. Held under the theme ‘Harmony in Innovation: Unleashing the Power of Nuclear Applications for Sustainable Development’, the event showcased cutting-edge research and fostered knowledge exchange and collaboration among local and international academics, policymakers, industry leaders, and stakeholders.