Adam said- The hospital's lawyers probably advised elevating the case to a judge to get an official ruling,
Justitia said- Adam...again you are incorrect. This will be my last post on this thread regarding the case.
I can speak with some authority regarding this case because I AM the J.D. in the video.
I performed a legal externship at the hospital under discussion, in the legal department under discussion, with the chief counsel and assistant counsel under discussion, and I know exactly what they thought, what they did, and why they did it.
While in law school, I found a rarely used Washington Supreme Court decision that I used to support a motion I filed with the court to grant me full access to this case's sealed court records. I appeared before the very same judge who originally ruled in the case. He granted my motion; hence, I have all the supporting documentation and the oral testimony from both court hearings. Therefore, I know who said what, when they said it, and to whom they said it.
So tell me, oh wise recent licensee, WHY did they seek a judge's protective ruling after the fact, a ruling that just coincidently helped bolster their defense in case the natural parents filed a wrongful death lawsuit against the hospital AND against the attending physician? Oh, don't worry about what legal pleadings they relied on in court, before the judge: WHAT ACTUALLY MOTIVATED THEM?
If you tell me it's for ANY OTHER REASON (eg out of the kindness of their , etc) than to defend themselves against a massive judgment/settlement (read: the $$$) when the hospital recognized it was being exposed to liability by staff providers who were going out on a limb by ignoring State law, then you are quite naive (and didn't learn as much during your clerkship(s) as you might think).
What exactly do you think the role of the hospital admin is, except to protect the interests of the hospital? Show me a hospital CEO who's going to expose their organization to massive judgments in order to stand up for the morality of a situation or what is "right", and I'll show you a soon-to-be ex-CEO.
(Perhaps if we talk after you've had 20 yrs experience 'in the trenches', you might respond differently.)
Justitia said- You may be a retired physician, but unless you are a retired pediatric physician, you are not fully aware of the nuances of minors, informed consent (or assent with minors), and the mature minor doctrine. That why there are unique pediatric bioethics conferences.
Such as? Give me ONE example of treatment of minors that is unique to say, what a non-peds doc practicing at a large hospital who treated minors wouldn't know? Lay it on me. Because the fact is, ALL providers are equally-vulnerable as targets when it comes to defending against a claim of failing to meet standards of care, exceeding one's permitted scope of practice, etc.
(And note I could say the same for you, that as a non-physician you really don't understand the nuances of Tx of minors, etc. In fact, many MD/JDs I've interacted with don't really know much outside of their specialty (eg ER doc) other than generalities which apply to ALL providers, and they're generally clueless as to standards of practice are within the other specialties (say, ophthalmology, nephrology, etc), which is why they seek expert advice from consultants within those specialties when deciding to take one a malpractice case.)
Justitia said- This case simply NEVER would have seen the light of day but for the anxious administrator. The physicians, social worker, AND legal department were united in the conclusion that medical staff have the authority to determine him a mature minor, respect his decision, and let him die, WITHOUT A COURT ORDER OR ANY FORM OF JUDICIAL REVIEW.
Note again that you're creating a straw man by implying I said something I didn't.
I NEVER SAID "JUDICIAL REVIEW" was needed, but said a consult needed to be obtained by a competent authority (eg by a bioethics committee) IN ORDER to avoid the perception of a sole physician 'going rogue' (which is what Marvin suggested, and I responded to). Please stop misrepresenting what I said (where a review of the thread clearly reveals what I actually said).
Justitia said- This hospital is a premier children's hospital, with some of the finest doctors in the nation, and if THIS hospital and its staff think they have that authority, then there is a good chance that OTHER pediatric hospitals/providers think similarly. If that is true, the chilling reality is that we don't really know how often JW minors die.
If that's "chilling" to you, then you might want to get comfortable with the LONG list of things that we actually don't know, and cannot ever hope to know, since that number actually is an indeterminate figure, precisely due to factors such as this.
Oh, and can we add the possiblility of similar cases existing to the list of reasons why it's foolish to even try to extrapolate such a figure from a single study in NZ, and to make any claims as to its accuracy (esp when the NZ study didn't even include minors, in the first place)?
The case of DL represents a break-down in the system where the treating doctor decided to 'go rogue' and ignore the advice of the bioethics committee (an action which, whether you admit it or not, created liability exposure for the hospital). That action alone would get a malpractice lawyer salivating at the prospect of taking the case, since your colleagues SEEK OUT such examples where doctors 'go rogue' and act beyond the limits which their State license allows (eg by allowing a minor to die who's under 18, where the concept of 'mature minors' hasn't been codified in WA State law). That's a winner for the plaintiffs, since a judge would be forced to follow the strict letter of the law as it exists at the time.
HOWEVER, the County judge's ruling in the matter was a gift to the hospital, since it makes the prospects of prevailing in civil court almost insurmountable, since the judge ruled that DL WAS a 'mature minor' (without saying it explicitly).
Justitia said- BTW, twice you felt the need to note that I said you were "totally" wrong. You aren't used to people telling you that, are you? It's a good thing you are retired.
I have no problem admitting when I AM wrong, even thanking someone for pointing out my error(s): aside from dogmatic JWs, who wants to be WRONG any longer than necessary? To do anything OTHER than learn from others is foolish, as ultimately it only deprives ourselves of the opportunity to grow and learn. Why would anyone do anything else?
I'm probably the most ego-free doctor you'd ever hope to meet, since I actually understand (and accept) the doctrine of self-determination, and allow the pt's ego and wishes to supercede mine, since it's their ego that matters (they're paying ME). They grant me the privilege of being their doctor, and I don't assume any RIGHT to do so, or DEMAND their consent. Maybe that's why I often had such good experiences with pts who had run-ins with their prior ego-driven docs, and garnered word-of-mouth referrals as a result.
Now, can you say the same? Can YOU admit to when you're wrong?
BTW, you didn't answer my question above (which I would've asked you directly, if I'd known you were the female in the video).
At the end of the day, EVEN KNOWING that the child was being coerced and was simply parroting words that they were prepped to say, etc. what are medical providers supposed to DO about the situation, if the court won't step in and order a BT?
Do you advise using restraints, sedation, or perhaps a tag-team of bulky hospital orderlies, etc?
In other words, aside from telling a roomful of physicians that they're being played (which is no doubt true), what are THEY supposed to do about it, esp if the pt fights off efforts to try to save his life?
The bottom-line was buried somewhere in the video, but at the end of the day it simply boils down to this:
Hospitals should seek a court intervention ASAP in these cases, since however much the JWs may protest and deny it, "Caesar's intervention" provides plausible deniability to the JWs, whereas the decision of a hospital bioethics panel or the like won't have the same effect.
Adam
