THE BLOG
07/17/2013 04:27 pm ET Updated Sep 16, 2013

Among the Most Serious Violations of Our Rights Occurs When We Sign an Informed Consent Form in a Hospital

Of late, the topic of our very rights as American citizens has moved to the front burner of our national consciousness. For weeks now, we have been shocked by the scope of the NSA's spying on Americans in cyberspace, with its access to our every communication via phone, email, Facebook, Twitter and who knows what else, all in the name of "national security." Indeed, our right to privacy has been compromised at such an unprecedented level it can no longer be tolerated.

Other cherished rights that we have enjoyed for decades are also under attack, such as a woman's right to make her own decisions about her health, which is being infringed by loony, right wing extremists like Governors Rick Perry in Texas, John Kasich in Ohio and Rick Walker in Wisconsin. These so-called "conservative" men -- who otherwise loudly balk at any perceived "attack" on personal freedom by the government -- are legislating what a woman can and cannot do regarding terminating a pregnancy, and when they can do it. Going even further back towards the dark days before Roe v. Wade , Perry wants to shut down 37 of 42 of Texas' abortion clinics, which also offer a host of necessary health services aside from abortion.

Then there is the ongoing hysteria and rancor about Edward Snowden blowing the whistle and leaking information about our government's obsessive intrusion into every facet of our lives. The debate rages on about whether Snowden is a traitor or a hero, but everyone can agree he is a man without a country, hanging in limbo as he seeks asylum somewhere while living for weeks in a Moscow airport. He is clearly a pariah in the eyes of the Obama administration, which seeks his return to the U.S. for trial. Let us also not forget Bradley Manning, who is beginning to fade from memory as he remains locked away in what many are calling inhumane prison conditions for similar offenses. We must know what our government is up to -- especially when it crosses the line -- if we are to call ourselves a truly representative democracy. In truth, that is all Snowden and Manning have done -- shine a light on the inner workings of the government we elected.

And what of workers rights and the right to unionize? Or voting rights and equal marriage rights? Or healthcare rights for the uninsured, so they can lead a healthy, productive life? Or the rights of those undocumented 11 million immigrants, waiting to become a part of the American fabric and pursue the American Dream? And let us not forget the right to retire with dignity with the Social Security and Medicare benefits we have earned. These programs have helped to make us a beacon to the rest of the world, showing our compassion and determination in protecting the health and welfare of the neediest among us. Sadly, that light has dimmed in recent years.

And, most egregiously, what of the right of young Trayvon Martin to safely walk down a street -- carrying nothing more than some candy -- and not be profiled and stalked by an armed neighborhood watch volunteer, George Zimmerman, who disregarded the authorities when they told him to stay in his car? Had Zimmerman listened, this young man would still be alive today. The very word "profile" was stricken from use in the trial by the judge, even though it is at the heart of this case. We cannot deny the ugliness of this word, or the outrageousness of Florida's "Stand Your Ground Law" that allowed Zimmerman to shoot and kill Martin and get away with it. When the verdict came in freeing Zimmerman from any responsibility for this tragedy, our nation rose up in anger and shock, and across the country people took to the streets by the thousands in protest. It is now up to the Department of Justice to step in and launch a civil action against George Zimmerman; but will it?

Little by little, every right we can think of is under attack for the benefit of a small number of corporatists that control our bought-out government. On a personal level, another fundamental violation of our rights -- which has been my concern for almost 20 years -- is what passes for "informed consent" when we enter a hospital for surgery or some other procedure. It really is a scam that should be renamed a "Waiver of Your Rights Consent." The Informed Consent form is, frankly, a document that absolves a hospital and its staff from any responsibility to the patient -- or should I say, to the "customer" or "consumer," as we are considered in this cockamamie healthcare system we have.

We are not blameless in allowing this violation of our rights to continue, as we are an uninformed lot who allow doctors and hospitals to blow us off with a lack of information about the procedures they will perform, or the failure rates, possible complications, follow-up treatments, alternatives, lengths of time for recuperation or rehab, and what those processes will actually consist of. Medications and their dangers are also skimmed over, before we can even figure out how to pronounce their names. Critical questions remain unanswered in almost every case, including key pieces of information like how many of those procedures the doctor has performed and how extensive and debilitating the surgery will be. The latest Informed Consent form I signed a few weeks ago for eye surgery even required me to state that "I acknowledge that no guarantees or assurances have been made to me as to the results that may be obtained," which all but assures no litigation right for me. They never stop thinking of ways to protect their own butts, do they? The doctor did privately promise a successful result, which he did not deliver.

Another of the "cute" passages in Informed Consent forms states that you have been given an opportunity to ask questions and they have been answered satisfactorily, when that actually rarely takes place. Usually, this form is handed to you to sign just as you are going into surgery, without being given any opportunity to read it or consider what questions to ask. And the teeny, tiny type doesn't help, either -- who carries their reading glasses in a hospital gown? It is a moment of great anxiety and vulnerability for anyone on their way to the operating room and, of course, the doctor and staff know that. The appropriate way to obtain a truly informed consent would be for patients to receive a detailed Informed Consent form no less than two weeks before any procedure, so they can discuss it thoroughly with their doctor in the doctor's office before signing, when a more level head prevails. Ideally, a friend or family member advocate -- should also be present, with a detailed list of questions that must be answered before they, too, sign the form as a witness.

Several states have a Patient's Bill of Rights, which can be accessed from those states' Health Departments and should be read by anyone going in for surgery or other procedures. You would then be as amazed as I was at the number of clear violations of a patient's rights that can be found in those consent forms, including the grant of permission to use a patient's blood, tissues and organs for research or teaching purposes, without an explanation of how they will be used, or the consequences. Such harvesting should require a separate informed consent form that provides detailed information on exactly how these precious items will be used.

Another missing element from these forms is the right to know who will actually do the surgery, something that is just as important as the surgery itself. Instead, an Informed Consent form usually says the "doctor and his/her assistants" will perform the surgery. Well, if it is a teaching hospital, there's a good chance the doctor will stand by as his medical students do the actual work, with patients serving as little more than training material for students to learn on. And that doctor you have sought out based on their high profile may also be a researcher testing new drugs, or a new, yet unapproved technique. That was one of my experiences when an orthopedist watched two residents and a fellow do my shoulder surgery some years ago, while testing a pain block on me that he had received $500,000 from two drug companies per year for five years to test. Twelve medical students stood by and observed -- did they participate in the surgery, too? Where was my signature authorizing that I could be put on display while in such a compromising position? What was expected to be arthroscopic procedure was instead a major, invasive surgery that kept me in the hospital for four days -- surprise, surprise.

Each hospital has its own Informed Consent forms -- there is no standardization -- but the tone is pretty much the same in all of them, focusing on protecting the hospital and staff from lawsuits and not doing enough to inform the patient. It would be a good idea to attach the state's Patients Bill of Rights to each Informed Consent form a patient receives, so that they can know their rights before signing it. The discrepancies would be startling. Some staff members will even forge a doctor's signature on an Informed Consent form, which is unacceptable and collusion. It is also not unheard of for a staff member, when asked what the form is for when giving it to a patient to sign, to casually state, "Oh, it's permission for surgery." Many of these forms have also not been updated for years. This is a major document used when your health and very life may be on the line, yet we are denied the right to make informed decisions about our own care. This matter should not be taken lightly, as according to the CDC there were 51.4 million inpatient surgeries reported for 2010, and according to a Reuters article by Allison McCook, there are 57 million out-patient surgeries per year.

Next week, I will be given the opportunity to draft a real, patient-centered Informed Consent form with the policy adviser for a state senator here in New York. I don't expect a revolutionary bill to pass that finally holds accountable the medical industrial complex that has long forgotten its credo of "First Do No Harm," but it could at least open up a dialogue on this long-hidden right of all Americans. It is our right and responsibility to be as informed as possible before any surgery. And maybe -- just maybe -- we need a test case or two from patients who refuse to sign an Informed Consent prior to surgery when their questions about the procedure are not addressed and they are handed one of these vacuous cop-out forms to sign.

The New York State Patient Bill of Rights says you can refuse treatment and be told what effect this may have on your health, yet this is not in any Informed Consent form I have seen. Also, you may refuse to take part in research, and are entitled to a full explanation before deciding whether to participate or not. It is interesting to note that Obamacare has no national Informed Consent provision in it, instead leaving it up to the states. I suppose that was yet another fight our President was not prepared to wage when pushing through that bill.

With Jonathan Stone