Medical Facility Allegedly Violates Doctrine Of Informed Consent

    Ethics Expert

    This case involves a medical group’s cardiac surgery license. It was alleged that a defendant medical facility refrained from sending patients to the plaintiff hospital. The plaintiff was a hospital that held a prestigious surgery license. In the 5 years before the case, 95% of the defendant’s patients were sent to the plaintiff hospital for treatment because the defendant lacked the applicable license to provide certain types of care and procedures. The year the case was filed, the defendant entered into an exclusive affiliation agreement with another hospital whereby the defendants’ physicians agreed to send patients to a hospital other than the plaintiffs. As a result, the defendant transferred less than 20% of patients to the plaintiff hospital. Contrary to the doctrine of informed consent, the defendant doctors refused to tell patients that plaintiff institution was an option for their transfer in order to effectuate the facility’s affiliation agreement. It was alleged that many patients over the course of the year would have elected transfer to the plaintiff hospital had the defendant told them of their options, as required by the law.

    Question(s) For Expert Witness

    • 1. What is your familiarity with publication standards, particularly as they apply to issues of honesty in citing materials?
    • 2. Is it necessary to alert the reader that a key passage in a publication has been changed in the later editions in a manner that undermines their thesis?

    Expert Witness Response E-030286

    I have handled a wide array of ethical violation cases during my career, in journals published on cardiology, hospital medicine, several social science titles, and in my current role as executive editor of a major surgery journal. I am extremely familiar with publication standards and I currently hold numerous association memberships including a leadership role with the World Association of Medical Editors, the Committee on Publication Ethics, as well as a former member of the International Society of Managing and Technical Editors, and the International Committee of Medical Journal Editors. Many ethical publication issues involve citation-related infractions, which should always be taken seriously and addressed promptly and honestly. Ignorance is not an acceptable explanation for failure to honor the rules. It is not only necessary to alert the reader that a key passage in the publication has been changed, it is mandatory. The work I do translates into how patients are managed, and their outcomes are a direct result. Once an article is formally published, changes should not be made without alerting the reader formally, typically in writing (vs online-only publication). Some issues are minor, and others have required retraction and legal counsel’s input to ensure the proper steps were taken and executed to the mutual satisfaction of the author/editor and the complainant. There are published standards for handling ethical publishing issues, and I have always followed the guidelines explicitly.

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