A recent New York Times article entitled “Dying in the E.R., and on TV” raises troubling issues concerning patient privacy and the emotional distress suffered by a family already hurt by the death of its patriarch.
In April, 2011, ABC-TV’s hospital-based reality show, “NY Med,” was filming inside NY Presbyterian/Weill Cornell Medical Center the night Mark Chanko was brought in. He had been badly hurt by a garbage truck outside of his Manhattan apartment building, and died later that night when his heart stopped. He was 83.
His widow, Anita Chanko, and their children grieved. But the pain came flooding back over one year later, when Ms. Chanko turned on her television, and saw her husband’s death on the screen–part of one of her favorite shows, “NY Med.” Though the image was blurred to prevent most from being able to identify him, Ms. Chanko recognized her late husband. She is quoted in reporter Charles Ornstein’s article saying: “You could tell it was him. You could hear his speech pattern. I hear my husband say, ‘Does my wife know I’m here?’ ” She then hears the medical staff discussing his deteriorating condition, the use of shock “paddles,” and whether they can pronounce him dead. A few weeks after the airing of the episode, Ms. Chanko heard from a family acquaintance, who also recognized him on TV.
The show is not strictly geared to the advancement of science and medicine, to say the least. As the article notes, the promotional blurb for the episode still says, “Sebastian Shubl, a Dr. McDreamy-like young trauma surgeon, tries to save the day when a critically injured pedestrian struck by a vehicle is brought to the E.R.” And hospitals love the free publicity. “You can’t buy this kind of publicity, an eight-part series on a major broadcast network,” gushed a NY Presbyterian public affairs executive.
Neither Mark Chanko, nor anyone in his family consented to the filming of his care at the hospital, and they were outraged. They filed complaints with the appropriate agencies, the hospital and ABC and they brought a lawsuit grounded in claims of invasion of privacy and intentional infliction of emotional distress. Ultimately, the Appellate Division, First Dept., dismissed all of the family’s claims. Despite at least anecdotal evidence that Mark Chanko’s privacy had not been protected properly, the Court absolved the defendants of all liability, finding that no identifying information had been released.
More troubling was its finding with regard to emotional distress. According to a leading case on the subject, the tort of intentional infliction of emotional distress has four elements:
(i) extreme and outrageous conduct; (ii) intent to cause, or disregard of a substantial probability of causing, severe emotional distress; (iii) a causal connection between the conduct and injury; and (iv) severe emotional distress. The first element–outrageous conduct–serves the dual function of filtering out petty and trivial complaints that do not belong in court, and assuring that plaintiff’s claim of severe emotional distress is genuine (see, Prosser, Insult and Outrage, 44 Cal L Rev, at 44-45; compare, Mitchell v Rochester Ry Co., 151 NY, at 110). In practice, courts have tended to focus on the outrageousness element, the one most susceptible to determination as a matter of law (see, Restatement [Second] of Torts § 46, comment h; Givelber, The Right to Minimum Social Decency and the Limits of Evenhandedness: Intentional Infliction of Emotional Distress by Outrageous Conduct [“Social Decency”], 82 Colum L Rev 42, 42-43 ). 
Howell v. New York Post Co., 81 N.Y 2d 115, 121 (1993).
The Appellate Division found, in essence, that though the family may have been distressed, and the defendants disregarded a substantial probability of causing severe emotional distress, there was no extreme and outrageous conduct, which, according to the case law, is virtually impossible to ever show. Former U.S. Supreme Court Justice Potter Steward said, “I know it when I see it.” But you do not have to be a legal legend to see conduct that is extreme and outrageous here. Anyone can, and should, see it. Because if this type of tawdry, craven and profit-driven treatment of a bereaved family isn’t outrageous, I’d love to know what is.
Would you trust a dentist to diagnose your sleep disorder? If you said “no,” the Texas Medical Association is on your side, and is taking its concerns to court. Why, you ask? Because diagnosing and treating sleep disorders is outside the realm and qualifications of dentists–at least it is if you are a physician and member of the Texas Medical Association.
But not everyone sees the issue in such black and white terms. The fact is that dentists do treat at least some sleep disorders, particularly when the treatment calls for the patient’s use of an appliance worn inside the mouth. And the American Academy of Dental Sleep Medicine is made of dentists devoted to the specialty. When I was treated by NYC-based dentist Michael Gelb, DDS, for TMJ, I learned that not only does he specialize in treating sleep apnea--he revolutionized its treatment with some of his own inventions.
So why would a medical association, the members of which likely swore an oath to support tort “reform” and never resort to something as sordid as the courtroom, sue to prevent dentists devoted to certain sleep disorders from treating them? I mean, this is Texas, bastion of large-scale tort-reform legislation by that celebrated visionary, Gov. Rick Perry. Might it be that these Texas doctors are concerned about the thickness of their wallets, and simply don’t want to let any business slip away? I’m just asking, because of course, I have no opinion. Really.
Words can mean a lot when patients are injured or killed by medical malpractice. First came the phrase, “I’m sorry,” which I discussed just over one year ago in this post. Even the medical establishment has recognized the true value of an apology, as they have come to acknowledge that medical malpractice lawsuits are not fueled by greed, but by anger at the failure to even offer these words of comfort after lives have been derailed.
So let’s move on to the next logical phrase. What would happen if doctors began acknowledging fault after making mistakes, particularly mistakes that caused serious injury or death? Ohio physicians are pushing for a law that would allow them to own up to errors, but would prevent such admissions from being used in court. Proponents of such legislation say that it could defuse the anger and resentment of victims of malpractice, since often, what they value most is a full explanation of what happened to them. Therefore, acknowledging that a mistake was made could lessen lawsuit filings. On the other hand, opponents feel such a law would be unethical, as the admission cannot be used in court, and would present a distorted view of the evidence at trial.
At first glance, the proposed law seems a bit too favorable for doctors and hospitals. If such acknowledgments result in fewer medical malpractice lawsuits, that is not necessarily a bad thing–if, and only if,victims are compensated in alternative ways, such as quick settlements that start them on the road to recovery. Such admissions might also facilitate actual learning from mistakes, as more, and more open discussion would lead to less stigmatism of those who make them, making the sharing of lessons learned easier to do.
What do you think?