What’s clearly missing from this is the Hospital/Doctor’s side of the story - but outside of evidence to suggest otherwise, they should have respected his wishes.
I also believe taht this man will eventually add to the statistics of “preventable prostrate issues that are easily identified by rectal exam but didnt so he died”.
Lots of ignorance out there.
Pregnancy test, yes. Go pee in a cup. But if a woman comes in with abdominal pains they’re not going to give her a pelvic immediately. Especially against her will.
However, if a woman got hit with a beam in the same manner, the doctors would still want to do the same rectal exam on her, so I’m not sure what your point is.
I do believe the man should be able to refuse any medical treatment, even if it is for silly reasons.
That’s not the point. The issue is whether or not he was mentally competent to refuse consent at that moment and whether the doctor had good reason to believe he wasn’t. The patient was lucid and coherent and voiced objections to a specific medical procedure. Over his objections he was forcibally restrained and reacted violently. It’s perfecty normal to react violently when someone’s trying to restrain you against your will. When he woke up he was in restraints and was then apparently taken to a police station (without being allowed to dress) to a police station and booked on assault charges.
Clearly, this is proof that his assault on the doctor was a homophobic hate crime.
Hell of a way to go out, a bonus for the girlfriend/wife too.
Ok, I’m going to chime in as an Emergency Physician. I obviously don’t know the specifics of this case and I wasn’t at the scene of this guy’s initial examination, but I always take newspaper reports of a case with a big helping of salt because they almost always have the patient’s story (with attached spin) and not the hospital’s story at all (their lawyers are smarter than that).
But there are very specific Trauma protocols. One of those is a rectal examination for potential or suspected spinal or head trauma and/or abdominal/pelvic trauma. Yes this is to test for rectal tone and/or blood in the bowels.
As for the legal issues at stake here, I do NOT know the laws in NY. But in general, patients with suspected head injury or intoxication are generally presumed to be unable to make rational decisions regarding their healthcare. In those cases, the patient can be medicated and/or restrained in order to procede with their evaluation by the ER or Trauma staff.
While one of the linked articles above says that the patient was “alert and oriented” on the way to the hospital, a lot depends on if he was alert and coherent when he got there. But let me tell you, if you start flipping out and taking swings at the staff we’re not just going to assume you’re an asshole, we’re going to assume you’ve got a head injury. Read up on ‘epidural hematoma’ and the ‘lucid interval’ and tell me if you’re willing to let a belligerent patient with a big fat laceration on his forehead make his own decisions.
My point is that if a lucid patient (he was considered alert and oriented times three, meaning he knew who he is, where he is and what day/year it is.) refuses a treatment, then it should not be forced on him. Just because it is a valid test doesn’t mean he has to agree to it. And, if he doesn’t agree to it then the docs should keep their fingers out of his ass.
And if they DO keep their fingers out of his ass and they miss a spinal injury or internal bleeding that later causes disability or death they’re going to be hauled in front of a judge and/or jury to explain why they didn’t perform a routine medical examination that might have caught said injury early enough to prevent permanent damage.
Survey says…
This one gets settled out of court.
If the doctor suggests a test and the patient refuses it (say an MRI and the patient is claustrophobic) wouldn’t the doctor write in the chart that the patient refused the procedure against medical advice? I know that if a patient leaves the hospital when the doctor tells them to stay that it is written up as AMA. Shouldn’t that alleviate them of any legal threat?
Not if the patient later claims that he had suffered a head injury and wasn’t able to make that informed decision. It’s a catch-22 and the physician is usually better off erring on the side of doing too much (from a medico-legal standpoint).
While that’s understandable, I don’t think you get to have it both ways - if you’re assuming the belligerence is due to a head injury, and not to a perfectly understandable reluctance to let someone poke their fingers in you when you feel fine, I don’t think you should get to charge him for assault as well.
This is not correct if you look at it from the ER perspective and not in hindsight. His behavior could have been due to alcohol for all the ER staff knows and we all know that intoxication does not alleviate a person from their responsibilities. Otherwise all drunk drivers would be let go. Taking a swing at an ER staff member is going to get you restraints and/or a visit from the police/hospital security in most cases.
In hindsight, the hospital may have felt that his behavior was NOT due to intoxication and possibly was due to a head injury and that was why they dropped the charges, I don’t know what the reasoning was. Keep in mind that all the information that is available now was not available at the time. That’s why we say that working in the ER is like working in a fish bowl. People on the outside looking in have a much clearer view of what’s happening.
It very well might have been SOP to file a police report whenever a patient physically threatens a doctor, regardless of whether it was the result of a head wound or mental illness or heavy drinking.
Hospitals are all about documentation, documentation and more documentation.
Looks to me like you have it backwards. He didn’t start swinging until they tried to restrain him and/or pin him to the table.
They did not drop the charges. The charges were dismissed by a judge.
The hospital didn’t drop the charges - a judge dismissed them.
And while I agree that being intoxicated doesn’t alleviate a person from their responsibilities, I find it hard to believe a person ever has a responsibility to allow a doctor to probe his rectum against his wishes. I don’t think he should win the lawsuit either, but if he was alert, coherent, and cooperative when he arrived at the ER, then started flailing around when they held him down to do the rectal probe after he told them not to, I can’t see how he acted illegally, regardless of his BAC.
And in the latest, and probably final, chapter, the patient’s lawsuit has been dismissed as well.
Link.
IMO, an ethically gray area. A mentally competent patient has the right to refuse any and all medical treatment, even if the result will be fatal. OTOH, a person with a head injury may not be mentally competent. Kind of a catch-22 there.