This case involves a medical ethics dispute between a hospital and a plaintiff outpatient rehabilitation facility. The defendant hospital entered into a kickback agreement whereby the defendant’s physicians agreed to send all rehabilitation patients to a facility other than the plaintiffs. The other rehabilitation facility was farther away from the hospital than the plaintiff by 25 miles and was smaller in size. Contrary to the doctrine of informed consent, the defendant doctors refused to tell patients that plaintiff institution was an option for transfer and actively prevented patients from being transferred to the plaintiff facility even though the smaller rehabilitation facility did not have the resources to keep up with the patients being referred to it. It was alleged that a significant percentage of the patients that were referred to the smaller rehabilitation facility would have chosen the plaintiff facility if they had been told of their options, as required by the law.
Question(s) For Expert Witness
- 1. Please describe your experience in medical ethics.
- 2. What information must be shared with a patient before they are transferred to another facility?
Expert Witness Response E-009609
I am an expert on legal and ethical issues in medicine. I hold two board certifications and I frequently serve as a media commentator on medical issues. I have served as an expert witness on medical ethics issues for the past 35 years and have reviewed a few cases concerning informed consent. The question of whether patients need to be told about all referral options prior to a referral being made is complicated. Much hinges on the comparability of the facilities. If there are substantial differences in the facilities that would have made a material difference to the patient, then patients should absolutely be told why a recommendation for a transfer is being made. Of course, patients have the final say.