I nearly missed this news article, which is too lengthy to reproduce in full. Here are the opening paragraphs and the accompanying commentaries by some lawyers.
A First: Doctors applied to court for permission to amputate patient's legs as she was in coma
A Twist: Order cannot be carried out as patient wakes up
By Karen Wong
January 26, 2006
IT is a legal first that comes with a medical twist.
The High Court has handed down an unusual order to allow doctors to amputate a diabetic patient's legs in order to save her life.
The order was sought by the woman's doctors because she was in a coma and her only kin here, her 16-year-old son, was too young to sign the consent papers.
Earlier, she would not agree to the amputation.
And here's the twist: after the court passed the order, but before the operation could be carried out, the 51-year-old woman woke up from her coma.
Now, as long as she remains lucid, doctors have to keep aside the court order and go by her wishes.
Lawyers: Case is significant
THIS is the first time that a hospital here has gone to court seeking such a declaration.
And, the court's landmark decision means that in future, doctors may not need to go running to court for such a declaration, when faced with a similar situation, lawyers say.
When contacted by The New Paper last night, Ms Kuah Boon Theng, a lawyer who advises doctors and hospitals, commented: 'We now know that Singapore has adopted the English law position, which is that in situations where a patient is not competent to decide, and when the procedure is in their best interest, doctors can proceed to provide the treatment.'
What is the effect of this court judgment on doctors and hospitals?
She said: 'In future, there may be no need for doctors to scurry to court every time they are faced with this same situation, to seek a court declaration.'
When contacted, Mr Christopher Chong, the hospital's lawyer, commented: 'If a comatose patient has not previously said anything, this decision confirms that doctors would have to treat the patient according to the best interest of the patient medically.
'But in unusual cases where there is uncertainty as to the patient's consent, there is now a procedure by which the lawfulness of the proposed treatment can be determined by the court.'
Although it remains to be seen whether the amputation will be performed in Madam LP's case, lawyers seem to be unanimous in saying that Justice Choo Han Teck's ruling will be relevant in similar medical cases.
Now you may think that angry doc will be jubilant at the fact that the court has essentially ruled that 'doctors know best', but I am actually very disturbed by the ruling. Again, it is difficult to judge what the doctors did with just the information provided in the article; the doctors who did what they did must have their reasons, but it seems to me this case violates the concept of patient autonomy.
I have previously been in medical teams managing patients whose lives were threatened by a gangrenous limb or perforated gut, but who refused life-saving surgery.
It was frustrating to watch them deteriorate day by day and sink into a febrile delirium when you know that we have the means to save the patient's life and all we needed was for him or her to say 'yes'.
Sometimes they changed their minds. Sometimes it was too late by the time they changed their minds.
But we never forced the issue. We knew that just because the doctor knew best, it didn't give him to right to do what he thought was best.
I think this court ruling actually made it harder for doctors from now on, rather of easier.
Will the doctor who genuinely wants to respect the wishes of a patient face a lawsuit from the patient's family if he would not apply a court order to over-rule the patient?
Will the doctor really be immune from a lawsuit from the patient who lived because of the court order, but now suffers 'a fate worse than death'?
How will you feel if you wake up from a coma to find a part of yourself removed against your expressed wish? Will you ever be able to trust your doctor again?
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