Fri, Jul 04, 2003 - Page 4 News List

Unneeded surgeries worry watchdog

By Melody Chen  /  STAFF REPORTER

Taiwan's women may be paying with their bodies for errors caused by the flawed design of surgical consent forms at Taiwan's hospitals and clinics, the Taiwan Health Reform Foundation said yesterday.

According to the foundation, every day there are about 13 women in Taiwan who have their uteruses mistakenly removed; that adds up to more than 4,700 women every year who have unneeded hysterectomies due to faulty decisions by doctors.

The foundation quoted a study by Chao Yu Yu-mei (余玉眉), dean of National Yangming University's School of Nursing. The study says that 20 percent of the 25,000 women who undergo hysterectomies each year are doing so needlessly.

The foundation distributed the report at a press conference yesterday to illustrate problems caused by what they say is the flawed design of the procedural consent forms.

Comparing surgical consent forms in Taiwan, Britain and Australia, the foundation asserted that one of the biggest problems with Taiwan's forms is that they fail to explain the risks and potential complications of the surgery being considered.

Chang Ly-yun (張笠雲), president of the foundation, said another study carried out in 1998 found that about 30 percent of the women who had their wombs removed did not have correct knowledge of the location in the body of the organ they lost.

"The study revealed only the tip of the iceberg for the numerous problems that occur when doctors do not duly inform patients of the things they need to know about their surgery," Chang said.

In contrast to Taiwan's forms, the eight-page hysterectomy procedural consent form used in Queensland, Australia is exemplary, said the foundation, which urged the Department of Health (DOH) to revise the standard format of the procedural consent forms here.

The foundation pointed out that the DOH's version of the procedural consent forms lacks four pieces of information which -- according to Article 46 of the Medical Treatment Law (醫療法) -- doctors are required to give their patients: the cause, success rate, potential complications and risks of the surgery.

The foundation suggested that the health department include 12 essential items in its standard procedural consent forms in order to improve patients' knowledge of the surgery they are told they must have.

Chang also recommended that hospitals be required to produce four copies of a procedural consent form for every surgery. That way, the patient, the doctor, the hospital and the Bureau of National Health Insurance would each have a copy.

The move aims to prevent doctors from performing unnecessary surgeries just to get payments from the health insurance bureau and to protect those doctors from legal disputes, Chang said.

"In fact, many unnecessary surgeries have harmed our patients, but the patients did not know it," Chang said.

With the health department ignoring problems caused by the flawed consent forms and the health insurance bureau hiding statistics about the hospital surgeries, the public could hardly grasp the extent of damage done by unnecessary surgeries, Chang said.

Cheng Tsung-ming (鄭聰明), a senior official at the health department's Medical Affairs Bureau, said it would be difficult to revise the procedural consent forms in line with the foundation's request.

"The consent forms would be as thick as books if we revise as the foundation suggested. Patients would not have the patience to read them through," Cheng said. "The most important thing is to strengthen the communication between doctors and patients."

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