Duodenal Switch: Bariatric Surgeons' Ethical and Legal Obligations

Go Diana!!!   I'm not very familiar with legal issues - is this effective from the date of these rulings or retroactively?  Could all those people who were never told about other options, including the VSG and DS, sue now, or would that only apply to people having consultations from the date of those rulings forward?  This is great news for patients everywhere of everykind! 

The usual caveats: I am not a litigator; I am not an insurance lawyer (yet?); state laws differ, etc.

However, it appears to me from what I have read that these ethical obligations have existed for many many years, and the legal cause of action of the failure to provide informed consent would apply retroactively (because it existed even without these cases).  These cases did not CHANGE any law, they applied the existing legal and ethical obligations and found the doctors failed to provide their patients with the required treatment options and thus denied them the ability to give informed consent to the procedure that was conducted on them.

Let the suing begin!

I am not an insurance lawyer (yet?) 

I couldn't think of a better person to tackle this head on.  Nor a better direction at this crossroads of your career!

Hmmm . . . . a failed VBG and a failed revision to that VBG, and I wasn't even told about the RnY!  The DS was for sure not out of the closet yet, back then, but the BPD and the RnY were.  I've lived with, and am still living with, food getting stuck because of the damn thing!

 Definitely seems as though just as much if not more liability should fall on the insurance companies that refuse to pay for the best surgery... I have not had many health issues in my life thank goodness, but I wonder if someone needing cancer treatment or treatment for heart conditions have the same limitations of treatment options that insurance will cover as some of us have getting our surgery of choice covered?

Very good point.  I would add to that, however, that the surgeons themselves play a big role in what insurance will cover.  If surgeons could make the same amount of money off of the DS as they do GBing, VSG, and RnY, there would be more explosure of the insurance companies neglect.

You have no idea how much I wish this type of ruling could be used in Ontario to WAKE UP those Ontario Bariatric Doctors who intentionally don't tell patients their options. It's sickening.

Hmm, maybe I should move my legal career in a different direction?  I would derive a great deal of pleasure in suing the Lapband and RNY mill surgeons who provide no information or incorrect and derogatory information about the DS.

Hi Diana - I would love for you to move your legal career in a different direction!  If I only had the $ (big loans now after paying $7500 to fight my appeal and then selfpaying for my lap DS with Dr. Gagner) - I would love to sue good ole dr dent at the weight loss management clinic in Ottawa.

I went to him to become learned on weight-loss surgery.  He told me only about roux-en-y and only one particular surgeon, Dr. Graber.  I had no idea DS, VSG and lapband even existed.  After I was approved for roux-en-y, I found out about DS - reapplied and was denied.

All through my appeal dent was paid $250 per hour to be a witness for OHIP (conflict of interest given I was his patient and he should have my best interests in mind).  He spent his time trying to destroy all evidence and expert opinions I submitted.

At the Appeal, I asked him if he had an obligation to inform me, his patient, of all options available to me.  Under oath, he said nope.

At the Appeal, I asked him if he was aware of a more recent Buchwald Report that was favourable towards DS, vs. the one he submitted.  He answered yes.

He should not be allowed to get away with such bull****  I wish I could sue.  Who knows.....maybe someday.

He is a complete arshole.  Has kicked people out of his office who wanted to discuss DS.  Arrogant arspick.

I don't know anything about Canadian law, or Canadian medical ethics rules, but if possible, I would hope he could be charged with violating them, and the OHIP board could be as well for using an "expert witness" who was prevaricating, testifying against the interest of his patient, and financially benefitting from what he was testifying to.