Court looks at consent in emergencies

New Jersey's top court will decide if physicians should have obtained informed consent from a patient's family when a postoperative complication arose.

By Amy Lynn Sorrel, AMNews staff. Dec. 18, 2006.

In a case that doctors say could significantly impact medical decision-making in life-threatening circumstances, the New Jersey Supreme Court will decide to what extent doctors must get informed consent before treating patients in emergencies.

If the court rules physicians must get consent, it could delay treatment critical to saving a patient's life; but if doctors don't first get consent to an emergency procedure, they risk getting sued, said Judith A. Wahrenberger, who represents cardiothoracic fellow James B. Hunter, MD, one of the doctors at the center of the case.

"It leaves doctors in the uncomfortable position of not being sure how a situation will be interpreted, and then you're in the dilemma of compromising patient care because you've done what you needed to do to get informed consent," she said.

Under New Jersey law, like most states, informed consent is required for any procedure or treatment, except under emergency circumstances.

Attorneys say that the court will likely open up the question of what constitutes a medical emergency when they look at whether informed consent should be required in certain situations. Doctors fear that if the court puts parameters on informed consent in emergencies, patient care will be put in jeopardy if juries can second-guess their judgment.

"It's a technical decision that needs to rest in the hands of physicians and their relationship with the circumstances at the time," not the courts, said Matthew M. Rice, MD, an attorney and former chair of the medical legal committee