Public complaints against malpractices of private hospitals and nursing homes overinflating bills by performing unneccessary or additional surgical procedures within a scheduled operation is often been heard of …but hopefully, not any more!
In a path-breaking ruling, the Supreme Court has levied legal obligation on all hospitals and nursing homes to get formal consent of patients before subjecting them to any surgery. Exceptional allowance may be given in such conditions that are life-threating for the partient and/or have considerable medical consequences. Under normal circumstances, if any additional surgical procedure is deemed necessary during the course of a scheduled operation, the medical team will need to wait till the patient regains consciousness and gives his/her consent for the same.
Uptil now, additional surgical procedures used to be performed with consent from relatives of the patient, while he/she was still at the operation theatre. Often, such situations were exploited to unneccessarily increase the billing amount, causing financial damage to patients and their families.
This ruling came in context of a case dating back to 1995, where a female patient was operated upon for removing her ovaries, while undergoing a diagnostic procedure at a private hospital. Although the court was agreeable to the fact that the operation was done for benefit of the patient, it held that it was done without consent of the patient, resulting in permanent disability to attain motherhood.
While announcing the judgement, Justices B N Aggarwal, P P Naolekar and R V Raveendran underlined the need for 'informed consent' from patients as a legally binding pre-requisite for all surgical interventions. The bench laid out a detailed guideline for doctors on “prior consent for additional procedures”. It was held that such a move will safeguard innocent citizens from getting duped in the hands of greedy hospitals.
Salient points of the Supreme Court guideline for hospitals and nursing homes are –
The fact that the unauthorised additional surgery is beneficial for patients, or that it would save considerable time and expense of the patient, or would relieve the patient from pain and suffering in future, are not grounds of defence against charges of negligence or assault.
The only exception to this rule is where the additional procedure though unauthorised, is necessary in order to save the life or preserve the health of the patient and it would be unreasonable to delay such procedure until patient regains consciousness and takes a decision.
Consent given only for diagnostic procedure cannot be considered as consent for therapeutic treatment. Consent given for specific treatment procedure will not be valid for conducting some other treatment procedure.
There can be a common consent for diagnostic and operative procedures when they are contemplated. There can also be a common consent for a particular surgical procedure and an additional or further procedure that may become necessary during the course of surgery.