Mother of Nine Sues Massachusetts Hospital After Unauthorized Sterilization

[bookitty]

Wrong. It means that just like I don't believe I should be jailed under the rules by which some people should be jailed or shot under the rules that some people should be shot, I don't believe I should be sterilized under the rules that some people should be.
But I definitely don't believe we have a right to have children or be parents, and so I believe that society has the right to take away our ability to do so.

Regulating instinctive behavior might be a bit tricky.

People are messy. They do stupid things. If you try to regulate everything that doesn't fit into a utopian ideal, you only get unhappy people who do stupid things and then become criminals.

 

[Rasmus]

But I definitely don't believe we have a right to have children or be parents, and so I believe that society has the right to take away our ability to do so.

You're in good company.

 

[drkitten]

So, how come you're in favor of forcing the hospital to provide documentation of consent, but not forcing the woman to provide evidence it happened at all?

Power differential. To do otherwise would be unfair to people who may not be familiar with standards of evidence.

Similarly, a person who appears in court pro se (for himself, i.e. not represented by a lawyer) is entitled by law to a certain degree of deference and guidance in filling out the forms and following the procedures. A professional lawyer is not entitled to such deference, and corporations (such as hospitals) are not even allowed to appear pro se. They must retain a lawyer to represent them, and their lawyer must follow the rules to a 'T' or risk having their case thrown out on procedural grounds.

In this specific case, the hospital should have a record of every procedure performed, every consent given, and supporting documentation to prove what procedures were performed, because that's simple professionalism. If the hospital can't prove that the woman was not given a tubal ligation, that looks very bad, because a professionally-run hospital would be able to prove it from the records they keep as a matter of course.

 

[WildCat]

If the hospital can't prove that the woman was not given a tubal ligation, that looks very bad, because a professionally-run hospital would be able to prove it from the records they keep as a matter of course.

How does a hospital prove they didn't perform a tubal ligation? You're asking them to prove a negative, often an impossible task. Short of videotaping every operation I don't see how this is possible.

 

[shadron]

There's nothing in that story which says that she actually did get a tubal ligation. It just says that she believes she got one. And given that she has won a lawsuit in the past for getting pregnant when using expired spermicidal cream (WTF? Spermicidal cream is not something that is guaranteed to work even when it isn't expired!), I think some doubts as to her motives are justified.

Ummmmmmm...scars? A Caesarian doesn't have them in the right place, and an IUD doesn't require any surgery at all (which makes the original story fishy). I don't think they do ligations from the inside yet, do they? And the sutures should be visible on today's quality of x-rays, I'd think.

 

[shadron]

But only on the poor, right?
Again, terrible incentive structure there.

If you go back and read the thread, Avalon, you'll find that drKitten made no mention of her being a poor case, only that she was a case. Regardless whether the hospital runs for profit or for charity, if it does medicine under the laws of the US then I think her judgment, if not her precise punishment, is fully justified. You cannot offer a lesser standard of ethics for the poor then you do the rich; if you do it at all, you do it right.

 

[drkitten]

How does a hospital prove they didn't perform a tubal ligation? You're asking them to prove a negative, often an impossible task. Short of videotaping every operation I don't see how this is possible.

... and a lot of hospitals do videotape every operation as a matter of routine.

A lot of hospitals also have routine post-op paperwork detailing what was done, paperwork that gets signed off on by all participants. If a doctor did a tubal and didn't put it on the paperwork, that would raise a red flag with the nurse (who watched him do it). The nurse might even mention it in her own report.

If the hospital introduces the report signed off by the surgeon, the assisting surgeon, the nurse, and so forth, and it doesn't mention a tubal, that's pretty good evidence that no such thing happened.

But if the hospital can't find the report,... well, that damns them. The obvious implication, which I would not hesitate to draw, is that the hospital HAS the report, that it mentions doing an unauthorized procedure, and that they're suppressing it. And I have no problem in this case taking the woman's unsupported word against the silence of the hospital where they should have been able to speak definitively. This is one of those instances where "her word against theirs" is not even, because the hospital shouldn't have to rely on just words.

And if the hospital doesn't keep reliable records of what operations are performed, they should lose the case (and their license) for lack of professionalism.

 

[ponderingturtle]

The hospital, yes. Colleagues, no.

People make this mistake all the time: They apply rules to a situation they aren't involved in, and completely fail to apply it to a hypothetical situation they COULD be involved in.

You ostensibly have a job. Are you suggesting that you yourself face a penalty, including a financial penalty, termination or jail time, when one of your coworkers screws up? Should you be charged with watching your coworkers at all times?

What about your opposing safety measures that would have prevented it?

 

[quixotecoyote]

... and a lot of hospitals do videotape every operation as a matter of routine.

That would be one way to do it. But let's say this one doesn't, since we have no way of knowing if it does.

And if the hospital doesn't keep reliable records of what operations are performed, they should lose the case (and their license) for lack of professionalism.

How would that prove what operations DIDN'T happen? If we're saying that they illegally performed operation X, they probably wouldn't have kept the paperwork but if we're saying that they never performed operation X, the paperwork never would have existed in the first place.

I don't think it's unreasonable to ask that someone demonstrate they were actually harmed before asking someone else to defend against claims of causing that harm.

 

[WildCat]

... and a lot of hospitals do videotape every operation as a matter of routine.

Really? How common is this? It doesn't seem like it's a popular idea from either side of the coin: http://www.mdinabox.com/articles/surgerytaping.pdf

Videotaping may well increase medical errors as surgeons worry about the camera instead of the surgery.

A lot of hospitals also have routine post-op paperwork detailing what was done, paperwork that gets signed off on by all participants. If a doctor did a tubal and didn't put it on the paperwork, that would raise a red flag with the nurse (who watched him do it). The nurse might even mention it in her own report.

If the hospital introduces the report signed off by the surgeon, the assisting surgeon, the nurse, and so forth, and it doesn't mention a tubal, that's pretty good evidence that no such thing happened.

But you're demanding a report not only on what was done, but on what wasn't done. An infinite list for all intents and purposes.

 

[AvalonXQ]

You're in good company.

Ah, Godwin'd so soon.
I'm simply not convinced that family planning is a right. But I'm aware that I'm in the minority on this.
Further discussion in this direction should probably move to its own thread, no?

 

[Rasmus]

That would be one way to do it. But let's say this one doesn't, since we have no way of knowing if it does.



How would that prove what operations DIDN'T happen? If we're saying that they illegally performed operation X, they probably wouldn't have kept the paperwork but if we're saying that they never performed operation X, the paperwork never would have existed in the first place.

I don't think it's unreasonable to ask that someone demonstrate they were actually harmed before asking someone else to defend against claims of causing that harm.

Yes, I think she should provide evidence. Of course, it might depend on the reaction of the hospital:

- Dumb: Oh, sure we did tie her tubes. What consent form? Oh, THAT consent form? why it was here a minute ago ... (Well, maybe not so dumb. If they are guilty it might help if they just fess up ...)

- Easy: Oh, sure we tied her tubes. she's asked us to do just that. And we have it in writing here. (A lawyer might well advise to use that approach.)

- Not quite as easy: We never! And we don't have non-consent forms, either. We tried, but we ran out of storage space half way through the first patient's paperwork... where's your proof?

- Difficult: Did she even ever have her tubes tied? Can she prove it? Can she prove the time frame it happened in? Can she prove it was us? (Again, a route I can see a lawyer taking ..)

 

[lionking]

Ah, Godwin'd so soon.
I'm simply not convinced that family planning is a right. But I'm aware that I'm in the minority on this.
Further discussion in this direction should probably move to its own thread, no?

Feel free. I would love to see you try to defend this position.

 

[luchog]

Pour encourager les autres. I wish to send a message to the entire health care profession that some levels of mistakes are not acceptable.

That's the entire purpose of punitive damages in the first place.

In particular, the mistake I wish to punish is the mistake of not double-checking your colleagues' work.

And to do that, let's punish the entire community; especially the poor who don't have alternatives for medical care.

 

[luchog]

You're in good company.

I would assert that this accusation is more appropriately levelled at drkitten. As others have already demonstrated, taking the actions described by drkitten, particularly with the nearly impossible standard of proof included, would result in the complete dissolution of the hospital system in the US, combined with an overwhelming disinclination to treat difficult or poor patients.

This environment would effectively eliminate healthcare for the poor, as well as for difficult and high-risk patients.

This specious overreaction makes sense only if such an outcome is desired. Spiraling malpractice insurance costs, combined with increasingly draconian government-mandated price controls has already created a healthcare crisis in the US; making it very difficult for the poor and working-class to obtain adequate healthcare. I fail to see how such a policy could possibly make this situation anything but catastrophic.

 

[Rasmus]

I would assert that this accusation is more appropriately levelled at drkitten.

I'm still not as certain that he's serious. Plus, I can't think of an appropriate Nazi-connection from the top of my head other than general and grave injustice.

As others have already demonstrated, taking the actions described by drkitten, particularly with the nearly impossible standard of proof included, would result in the complete dissolution of the hospital system in the US, combined with an overwhelming disinclination to treat difficult or poor patients.

Agreed.

This environment would effectively eliminate healthcare for the poor, as well as for difficult and high-risk patients.

More so, it would make it even unaffordable for people that are far from poor.

This specious overreaction makes sense only if such an outcome is desired. Spiraling malpractice insurance costs, combined with increasingly draconian government-mandated price controls has already created a healthcare crisis in the US; making it very difficult for the poor and working-class to obtain adequate healthcare. I fail to see how such a policy could possibly make this situation anything but catastrophic.

Yes - i think it's a ridiculous solution.

Mandated birth control and sterilization, however, is not as such ridiculous; it would work - in a way. It's just happens to be outright evil on many, many levels.

 

[ponderingturtle]

I would assert that this accusation is more appropriately levelled at drkitten. As others have already demonstrated, taking the actions described by drkitten, particularly with the nearly impossible standard of proof included, would result in the complete dissolution of the hospital system in the US, combined with an overwhelming disinclination to treat difficult or poor patients.

This environment would effectively eliminate healthcare for the poor, as well as for difficult and high-risk patients.

This specious overreaction makes sense only if such an outcome is desired. Spiraling malpractice insurance costs, combined with increasingly draconian government-mandated price controls has already created a healthcare crisis in the US; making it very difficult for the poor and working-class to obtain adequate healthcare. I fail to see how such a policy could possibly make this situation anything but catastrophic.

Um you are aware that as a percentage of the medical budget malpractice costs have been constant right? It not true to say that there are "Spiraling malpractice insurance costs" but rather spiraling health care costs.

 

[Rasmus]

Ah, Godwin'd so soon.
I'm simply not convinced that family planning is a right. But I'm aware that I'm in the minority on this.
Further discussion in this direction should probably move to its own thread, no?

Yes, it should be. So I've opened a new thread here and copied what I saw on this subject from here.

 

[KoihimeNakamura]

1) Hey, Dorion. I am actually responsible on my shift (at a gas station) for making sure all the work is done, regardless if I was the one who was supposed to do it or not. (As a side note, no one else usually does it.)

(Also, "absence of evidence is evidence of absence" is a logical fallacy.)

2) While I.. think Dr.K's overkilling the scenario (certainly, replacing the administrative staff + people immediately involved is a good idea... the entire hospital?) , he has a point, and that is You Do Not Do This Ever., using the draconian punishment as a reason why not.

(Finally, I would also like to see the other side of this argument.)

 

[quadraginta]

Ah, Godwin'd so soon.
I'm simply not convinced that family planning is a right. But I'm aware that I'm in the minority on this.
Further discussion in this direction should probably move to its own thread, no?

I don't think that this reference counts as a Godwin, unless you are saying that the field of eugenics, which you appear to be advocating, was utterly discredited by Hitler's acceptance of the idea. This would make your position a somewhat uncomfortable one.

It's valuable to remember that Germany's ideas about eugenics were largely imported from U.S. practices. By way of example Margaret Sanger, of Planned Parenthood fame, was not an absolute foe of forced sterilization. She condoned it for the "feebleminded". Her views on racial superiority were fairly clear as well. Although her personal ethics were admirable by the standards of the time it is important to note how easily they were distorted into something quite reprehensible.

This is an important lesson to take away from the eugenics debates of the early twentieth century. Very relevant to this discussion and the position you are espousing. Not a Godwin at all.

ETA: Copied to new thread. Reply here