Doctors and liability question

[Glados]

Should a doctor refuse a life saving surgery in order to avoid a lawsuit if the patient does not make it through surgery due to a different medical condition?

I know a person who almost was denied surgery to remove a malignant tumor because of high blood pressure. This person was at a low to moderate risk of heart attack and the surgeon did not want to be liable if the stress from surgery/recovery caused a heart attack. The tumor has not spread yet but it is a type that will spread slowly and is fatal if untreated. Thoughts? Opinions? I am not sure where I would say the line is between life saving and life risking.

[Seifer]

The problem is that people scream at doctor's and tell them, "It's the right thing to do!", yet when a complication arises through no fault of the doctor, the patient and/or their family sue the doctor for everything they're worth. It's a Catch-22 for the doctor - save a life and risk losing thousands upon thousands of dollars in a lawsuit (and/or having to pay higher insurance premiums), or refuse the treatment and be called an evil asshole.

[Silverharp]

That's what release waivers are for. It's asad state of affairs that people are so dman sue happy that doctors are hamstrings by hospital policies regarding that type of situation, or so afraid of losing their medical licenses that they can't help.

[Seifer]

That's what release waivers are for. It's asad state of affairs that people are so dman sue happy that doctors are hamstrings by hospital policies regarding that type of situation, or so afraid of losing their medical licenses that they can't help.

I'm sure an expensive lawyer can work around a waiver. If they claim that their client was too grief stricken/stupid to understand what was going on, the doctor could still face liability.

[HYHYBT]

It's not just fear of lawsuits. It's the principle "first do no harm." If the reason for not doing the surgery is that another condition makes the surgery too dangerous, then that other condition should be fixed first. Get the blood pressure under control, then they can remove the tumor.

(It might well make a difference if the problem the surgery was to correct was more urgent. And please don't confuse "serious" with "urgent" in reading that.)

[draggar]

Let's see, my wife dislocated her hip twice.

Hospital #1 - refused to do anything until I paid the copay in full - and refused to re-reset her hip after the x-ray tech re-dislocated it (yes, I saw him do that) until I paid another $500.

Hospital #2 - "on call" orthopedic doctor refused to come in to take care of it (happened at 1:30 AM). He also refused to see her when he first came in, we had to get another doctor to do it - 15 hours later w/ no meds.

Both times many lawyers said we didn't have a case.

You be the judge.

[Lachrymose]

My father had a congenital problem with his heart valve. About 18 years ago, he had it replaced with a bovine valve. The doctors told him it would need to be replaced again in about 10-15 years, due to deteroriation.

About three years ago, it came time. However, due to the fact my father was a heavy smoker since age 13 (he was 69 at the time), they were afraid his lungs were too frail to be able to handle the valve replacement procedure.

There were nine doctors with varying degrees of non-invasive valve replacement procedures at the University of Maryland Hospital (very prestigious in cardiac surgeries).

He was denied by all of them and died about a week later.

I remember asking my uncle, who has been a nurse for about 40 years, how they could deny possible life-saving surgery like that. "They're human, too!" he told me.

[MaggieTheCat]

I am confused... how can a doctor can be so concerned about something potentially going wrong during a surgery which might result in a patient dying, but the same dr. not concerned about not doing the surgery which will result in the patient dying? In the OP's case, it sounds like the patient in question has some time before the tumor becomes fatal, so there is time to fix the blood pressure problem. But in Lachrymose's story, her father died very quickly it sounds like, so the surgery was necessary for his survival and yet those drs. denied him because his lungs might not be able to handle it.

I don't get how doing something which may result in someone's death but will otherwise save their life is worse than doing nothing which will for sure result in someone's death.

[Lachrymose]

Honestly, I mostly understand, though I was frustrated with it at the time.

None of the surgeons want blood on their hands (so to speak ) . Refusing to help is not the same thing as someone dying by your hand. Or under your watch..or whatever.

ETA: His lungs were very, very bad. He probably would have died in surgery.

ETA2: Hmmm...why doesn't this same type of thinking hold up in an ER? Now I'm confused..

[draggar]

One important question - are you sure it was the surgeon who refused to do it, or was it the hospital, or the insurance company?

[Lachrymose]

Most, if not all of the surgeons came into his room (while I was there) and said the risk was too great.

It certainly wasn't the insurance company (which was Medicare anyway. I don't know what if anything they're allowed to deny). I guess it COULD have been the hospital (but on very strong counsel of the surgeons).

[BlaqueKatt]

I don't get how doing something which may result in someone's death but will otherwise save their life is worse than doing nothing which will for sure result in someone's death.

Because a lawyer will try to claim the physician was negligent in performing the surgery with an underlying health risk.

My first stepfather died of an aortic aneurysm that ruptured, they knew it was there but due to his high blood pressure, and him being a hemophiliac, operating would've likely killed him as well(he had less than a 10% chance of survival). At least he died without the pain of surgery. It ruptured, he felt sick to his stomach and was dead in less than 20 minutes.

Look the outrage at people like mickey mantle and steve jobs, who got new organs because the decisions they made damaged their own*, only to die within a few months.

*read the articles, jobs opted for macrobiotic diets rather than surgery or other treatment which with the cancer he had, conventional treatment would likely have "cured" him, Mickey mantle, drank through his own liver and when they opened him up for the transplant "found" stage 3 lung cancer.

[Nyoibo]

It's also a problem with the medical system, surgeons are hired based on their performance stats, a surgeon who takes the risky cases and looses patients will not get hired, so if they want to work and have a chance at a career they have to take the easy and safe procedures.

[Glados]

Wow, it sounds like there is a lot more to a situation like this then I thought. Thankfully they decided to do the surgery in the end. Thank you all for your input.

I thought that doctors can also be sued for not doing a necessary procedure, or am I mistaken? (not in this situation but if the situation is more immediately life or death)

[Nyoibo]

As far as I know they can't, you can't force someone to do something like that, unless there is no alternative, I think...