Duty of Care
Once a doctor-patient relationship has been formed then certain legal consequences follow.
Doctors and other HCPs have a "duty of care" to the patient.
A doctor's duty of care to the patient includes:
- To attend
- To diagnose
- To refer
- To treat
- To instruct
Duties which are closely related to informed consent are:
- To recall (continuing duty to disclose risks)
- To disclose medical mistakes
In many situations (for example if the patient is admitted to hospital), the doctor is not the only health care professional (HCP) who owes a duty of care to the patient.
For example the anesthetist is responsible for giving the anesthetic competently and the surgeon for performing the surgery.
Hospital regulations and practice generally establish where the responsibility (duty) lies. To some extent a doctor has to assume competence on the part of other HCPs who are part of the team or the system could not function.
Very often there is some overlap and there are limitations on how much a doctor can rely on the duty of other HCPs.
Foote v Royal Columbian Hospital
A doctor had altered a patient's anticonvulsant medication which left the patient at significantly increased risk of a grand mal seizure. He did not advise the hospital staff of this and the patient had a seizure during an unsupervised bath. The patient suffered significant brain damage as a result. The court held that the doctor was liable - had the nursing staff known, the patient would not have been left unsupervised during a bath.
Where many physicians are involved in the care of a patient, each may assume (wrongly) that the other physicians have taken appropriate action when they have not. When a patient suffers as a result, courts may apportion liability between all the doctors involved in the patient's care.