Assignment 4.1: Obtaining Consents

In this assignment, consider situations when consents may or may not be appropriately obtained.

Read the following case information to prepare you for this assignment: Health Care Crimes Case Study.

In less than six hundred words, you are to write a memo to the CEO of your hospital. Identify each opportunity during Mr. Roberts' time within your hospital where consent may have been obtained and whether that consent was implied or express and if express what type of express consent. Since your CEO may not understand the difference, you need to include a short definition of any type of consent identified. You also need to identify whether the consent was appropriately obtained, including why or why not. Lastly, you should provide your opinion regarding whether Mr. Roberts (or his guardian or heirs) has a possible claim against the hospital for permanent injuries and how that claim arises (for example an intentional tort and/or negligence).

Include APA style citations in text for all sources, including course materials. Remember that course materials need not be included in your references page, but all other references must be.

Case Study: Health Care Crimes Case Study

James Roberts is a patient in the hospital for which you are the director of risk management. Mr. Roberts was admitted ten days ago for head trauma suffered as a result of a motorcycle accident. He was initially brought to the Emergency Department by Life Flight (an air ambulance system) and was admitted to the neurological intensive care unit after having surgery to remove a piece of his skull to relieve intracranial pressure that would have resulted in permanent brain damage if it had not been performed immediately.

Mr. Roberts is not married, and his only child, a daughter named Mary, was located on the third day of his admission. During a telephone call, Mr. Roberts' nurse informed Mary of the need for Mr. Roberts to return to the operating room for another procedure which was intended to reduce swelling of the brain and help him to be removed from a medically induced coma. The nurse explained all of the risks, benefits, and alternatives in detail to Mary. Mary agreed to the procedure. The procedure was successful and on the seventh day of admission, Mr. Roberts was completely out of the medically induced coma, although he remained very confused. On the following day, Mr. Roberts' physician informed him that a third and final procedure was required to replace the portion of the skull that was removed during the first procedure.

The physician attempted to explain the benefits, risks, and alternatives to Mr. Roberts but due to his continued confusion the physician gave up providing a full explanation, had Mr. Roberts sign the consent form, and took him on to surgery. Unfortunately, the procedure did not go as well as planned, although it was technically performed appropriately, and Mr. Roberts relapsed into a coma.

On this tenth day of admission, Mr. Roberts' long-time girlfriend comes to you and informs you that she holds the healthcare power of attorney. She additionally informs you that Mr. Roberts has a living will and he did not desire to have heroic intervention utilized if the need arose. Mr. Roberts' girlfriend is angry because she does not believe that appropriate consent was obtained for any of the procedures.

After your meeting with the girlfriend, you return to your office to contemplate what you have just been told. Understanding the facts as above, you pull out your note pad and begin making notes and thinking through all of the possibilities.