Quantity with Quality
Physicians Do Not Always Know What is Best for You
How a series of court cases established the modern definition of informed consent
This is my next story in a series of articles responding to Dr Mehmet Yildiz’s challenge to produce a short quality article with three take home points each day for thirty days.
I have chosen to use Wikipedia’s main page as inspiration, choosing one item from the “Did You Know” section as topical encouragement.
On January 8, 1954, 55-year-old Martin Salgo underwent an aortogram procedure to determine the extent of potential abdominal aorta occlusion causing weak distal leg pulses and a limp in the patient.
After the procedure, Mr. Salgo woke up paralyzed in both lower extremities and subsequently sued the physician, Dr. Frank Gerbode and Stanford University Hospital for malpractice. The suit was decided in the California Court of Appeals with Salgo awarded $213,355 for damages.
What is notable about this cycle of events is that the case, Salgo v. Leland Stanford Jr. University Board of Trustees helped establish the concept of Informed Consent as we know it today. Informed consent is the process of getting permission from a patient before embarking on a medical procedure.
The concept of informed consent revolves around what information a competent patient needs to be able to make a reasonable decision about undertaking a medical procedure. Mr. Salgo was not informed about the risks and benefits of having the aortogram that ultimately caused his paralysis and his lawyers argued successfully that he was harmed without being involved in the decision to undertake the procedure.
What We Can Learn from a Mr. Salgo’s Experience
Informed consent wasn’t completely defined as a result of Mr. Salgo’s case, but rather several further-defining cases help build the informed consent concept in modern medicine.
One of the concerns was inundating the patient with so much medical information and jargon that they experience an “analysis paralysis” where the deluge of too much information makes it impossible to decide. Specifically, the Cobbs v. Grant case in 1972 set out the definition of what a competent person would need to know in order to make a reasonable decision.
Take home points:
Know what you are getting into. Just because someone is an expert in a particular discipline or field, you shouldn’t necessarily rely on only their opinion about things that affect you. Do some research ahead of time. Ask multiple experts for their opinion.
Physicians don’t always know what is best for you. A doctor only knows what they know. They may be the medical specialist, but medical intervention is often only a portion of the big picture of your total health. They often don’t know your familial or social issues unless you tell them.
You are your own best advocate. No one knows you and your best interests better than you. While family, friends and outside experts can offer their best-intentioned opinions, it is always up to you to preserve what is important to you.
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Timothy Key spent over 26 years in the fire service as a firefighter/paramedic and various fire chief management roles. He firmly believes that bad managers destroy more than companies, and good managers create a passion that is contagious. Compassion, grace and gratitude drive the world; or at least they should. Follow me on Instagram, Facebook, and Twitter, and join the mail list.