Our June Bulletin featured an article
about a medical practitioner’s obligations when ordering tests or investigations that, in the practitioner’s mind, are not necessarily clinically indicated.

case-study-snake-oil

The same ethical dilemma and potential legal exposure can arise with practitioners providing treatment that they know very little about, as the following case study demonstrates.

A general practitioner had a young patient who was terminally ill with advanced cancer.

The patient’s husband was desperately looking for a cure for his wife or, at the very least, to prolong her life.

The ‘miracle’ cure
As has become commonplace, the husband consulted Dr Google and discovered a medical practice in a foreign country claiming to have a treatment. The treatment involved a live virus being injected into the body to ‘fight’ the cancerous cells.

The husband intended to fly to the foreign country, purchase a large quantity of the virus and bring it back to Australia. He sought the practitioner’s agreement to administer it to the patient.

The practitioner made some enquiries with the TGA and ascertained that the treatment was not registered in Australia. In his own view, the treatment was futile and a waste of money and he advised the husband accordingly in a diplomatic way. Despite that, the husband insisted the practitioner administer the treatment.

The practitioner sought our advice.

MIGA’s advice
The practitioner was advised that:

  • His ethical and legal obligation was to the patient and not to the husband and, first and foremost, he needed to discuss the proposed treatment with the patient including his reluctance and unease with the treatment
  • In the event the patient agreed to have the treatment, the practitioner did not have a legal obligation to carry out the patient’s request on the basis that he did not believe it was clinically indicated and had very little knowledge about it
  • If he agreed with the patient’s request he should ensure that his discussion (with the patient and her husband) about the experimental nature of the treatment, the unknown benefits and potential complications and side effects are fully documented with the patient ideally co-signing the medical record or a consent form acknowledging the advice given
  • Despite informed consent being obtained, should an adverse outcome occur there was a risk the Medical Board would take a dim view on a practitioner administering treatment that they were not familiar with and which the practitioner did not believe was clinically indicated. While it is unlikely that the patient would bring a claim for compensation, the Medical Board’s charter is to protect the public and may take disciplinary action against the practitioner.

There is often an internal conflict for practitioners trying to deliver optimum patient care and comply with patient’s wishes balanced with their own obligations as medical practitioners to ensure treatments are clinically indicated and in the patient’s best interests.

Such conflicts may arise in all range of specialities and across the broad spectrum of the provision of health services.

Should you find yourself in a similar dilemma, we encourage you to contact our Claims and Legal Services team and speak to one of the solicitors to explore the pros and cons.

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