Vulnerable at risk - advocate

Changes to New Zealand’s medical ethics could lead to a repeat of one of its worst breaches of patient rights, a health advocate has warned.

The Health and Disability Commissioner finished consulting on Sunday on the rights of patients when they are unable to provide consent.

However, concerns have been raised that a review could open up further risk to those most vulnerable.

There are also worries a scenario similar to the Unfortunate Experiment, where treatment was withheld from patients at National Women’s Hospital in Auckland, could happen again.

Federation of Women’s Health Councils co-convenor Barbara Robson said the issue was not black and white.

Under the present law in New Zealand, patients in comas can be experimented on without their consent. Doctors can proceed if they prove research is in the patient’s ‘‘best interests’’.

However, next of kin cannot give consent on behalf of another adult, except in specific circumstances. A law change would be required for that.

Robson said it was not just a legal issue, but an ethical one. She questioned who decided what the best interests of a patient were.

She also worried that the ethical review process had been watered down.

‘‘The [Unfortunate Experiment] could happen again if the drivers are the wrong ones, if [ethics] continue to be watered down and the protection of patients is not the most important priority of ethical reviews.’’

Michael Hills was in an induced coma for 21 days after a car crash in 2003.

He was 18 at the time. Though he had no obvious physical injuries, his brain bore the brunt of the crash.

‘‘My short-term memory was non-existent.

‘‘If you told me something, I could not tell you it a minute later.

‘‘I have been going good for a few years now but it did take a while.’’

Hills is now a husband and father of three and works on a dairy farm in Feilding.

He said doctors were prepared to operate on his brain to relieve the swelling, but he responded before this was necessary. He said doctors did the right thing.

‘‘If you’re in that position, I fully believe the doctors can make the calls.

‘‘They want what is in the best interest for you.’’

University of Otago medical ethics lecturer Dr Angela Ballantyne said research had to go through far more ‘‘checks and balances’’ than general treatment did.

General treatment could vary between hospitals and clinicians.

‘‘There has to be a bit of trust that doctors are there to help, and they would not agree to do research if it was not in the patient’s best interest.’’