Informed Consent as Farce

A class action lawsuit was recently filed and certified against a Central California nursing home for systematic violations of its residents’ rights to give or withhold informed consent before being administered psychotropic drugs. The case is perhaps the best example yet of how and why the informed consent process in California nursing homes is often a total farce: the doctors don’t get consent, the nurses lie about it, and residents are unwittingly turned to zombies.

A key piece of evidence in the case is two incredible doctor declarations.  Both doctors explain they have had many resident patients in the facility over the years, many of whom were prescribed psychotropic drugs.  And then they drop the bombshell: they virtually never explained the drugs or sought informed consent as the law requires.  The doctors did not even know what the laws were.  The facility used informed consent forms, which the doctors signed, but the doctor would sign them en masse without reading them.  The forms were a fraud.

One of the doctors (a former medical director at the facility) commented on the testimony of nurses who had described the facility’s informed consent verification process.  He called their statements “ridiculous.”  The doctor recounts a much different process:

“I would typically receive a call or answer a page and learn of a behavioral problem regarding one of my patients for the first time over the phone.  On the same phone call . . . I would prescribe a medication and it would be administered as soon as they received it.  No nurse ever told me, in such a phone call, that I needed to call the family [to obtain informed consent]. Because the nurse was notifying me of the behavior, it’s not possible that the nurse thought I had already talked to the family.”

The process described by the doctor is exactly the type of nursing home practice that CANHR is committed to eradicating.  We have a nursing home that reaches out to doctors to chemically restrain residents, a doctor willing to prescribe psychotropic drugs to control “behavior” he has not observed, and a resident totally left out of the process.  Nursing homes and doctors that continue to operate this way do so at their peril.

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About achicotel

Anthony Chicotel is a staff attorney for CANHR. His areas of expertise include the rights of long-term care residents, nursing home litigation, health care decision-making, and conservatorships.
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