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December 22, 2013 in
Most Western European and North American social and medical systems operate under the primary ethical principle of autonomy. This principle allows the individual to determine the degree to which he or she will participate, or not, in any specific activity, including health care. For the patient to exercise autonomy, he or she must have a degree of understanding of his or her choices. Hence, medical providers have a subsidiary ‘‘duty to inform’’ the patient about possible diagnoses and obtain informed consent for performance of indicated tests. This allows the patient to consider a risk/benefit ratio meaningful to him or her.
8 Academic Emergency Medicine 12, at 1197.
The principle of autonomy and the duty to obtain informed consent are such commonplaces that the authors of that article didn’t even find it necessary to provide a citation: Rest. Obv.
How peculiar, then, that twelve years later one of the authors, Dr. Michael Parsa, should be sued for performing intrusive medical procedures on a patient against the patient’s express wishes.
(H/t Cath.)
How ironic.
I do hope the Medical Board doesn’t take a pass on this one.
Mark,
I want to applaud you for commenting on this more. Thus far, I have found more information concerning Parsa than I have Cabanillas (not to mention Portillo and Herrera). Can you do a separate post on Cabanillas? Thank you.
Either he was full of crap back then (not all that likely) or he slowly turned into a real Piece of S****. I suspect that what happens is that when the police bring people in, they are a ‘perp’ not a patient (as though the concepts are mutually exclusive). I’m sure he wouldn’t dream of doing this to someone that wasn’t in custody which if true, is the really troubling part. Fortunately, your blog has a lot of Google Mojo and he’s already becoming infamous – hopefully the fear of being a nationwide pariah will convince others that they shouldn’t become extensions of the police state.
Mark – a while ago it seemed like Radley Balko would post an occasional bit on Puppycide (cops killing someone’s dog, often on bad warrants) – then it seemed very quickly it was like every week. It seems like these incidents are happening more frequently in disparate areas. Do you think it’s a trend or is this just something fairly isolated b/c of how Texas has treated others? Killing dogs is one thing but it’s hard to see anyone, from a hard liberal to a law and order nazi type being ok with this. It seems though with infringements, it’s the slow boiling frog scenario – I sure hope not. Also it seems that in a lot of these cases, they could just wait and if there’s drugs, they’ll come out. I wonder if it’s b/c they can’t necessarily hold the person that they try to force the issue, knowing they can’t justify holding them for a day or so without a reason – so they try to rush it convinced they’ll find something? Kudos for pushing back man – thank God there are people like you.
This is Dr. Michael Parsa. It has come to my attention that when searching for me on the internet, this link is at the top of the list. Let me provide your readers further details.
This article is based on the lawsuit filed by the ACLU and taken directly to the press. The ACLU did this in order to put pressure on the hospital to push them to a quick settlement, after all, negative press is bad for business.
It is important to keep in mind that when a lawsuit is filed it is one-sided. It does not present the other side of the story. The information you have here is precisely that. The defendant typically is not able to respond to allegations publicly per legal counsel. Now that this is in the past, let me provide some details for your readers.
First, I never touched this patient. I did not do any pelvic exam or rectal exam on this patient. You may wonder how they are able to state such things as fact if they are not even true. The ACLU has not provided an answer to this, nor apologized.
Let me tell you what did happen that night.
This patient was brought in by the Customs and Border Protection agents for suspicion of smuggling drugs across the border. They requested an exam of the patient without consent (body cavity search) to search for contraband.
I spoke to the patient. I asked if she would allow us to do the exam as requested. She said no. I then went and spoke to the officer and told the officer that she was not consenting. The officer explained to me how high their suspicion was and made it clear to me that they had the authority to have this done and that they really wanted this to be done even if it was without consent.
I went back and spoke to the patient, explaining to her my conversation with the officer. The patient then allowed my designee (Dr. Cabanillas) to do the exam without resistance. The exam was similar in nature to a typical pap smear that women often have. The patient and ACLU never alleged any physical force such as being held down.
That’s what happened. What did I do wrong? Two things. First, I listened to the officer and I did not ask for proof that she had the proper authority (warrant) to do the exam without consent. The reason I did this was because I thought I’d just go back and ask the patient a second time. If she had again refused, I would have gone back to the officer. I was not about to have the patient held down for the exam.
Secondly, I asked twice. I should not have asked twice. The patient made it clear the first time when she said no. Even though I did not use harsh or commanding language, by explaining my conversation with the officer to her I was pressuring her to consent. This is not acceptable and should not have been done.
The patient claimed that this experience caused her psychological distress and was awarded over a million dollars from law enforcement and the healthcare entities involved. As a result of this case federal agents, at least in our region, do not bring suspected body packers to local hospitals for searches any longer.