MS>
MSGID: 1:3644/6 319e920f
MS>SCHOOL HEALTH EXAM ???
MS>     Numerous parents in East Stroudsberg, Pennsylvania are irate
MS>over their public school system having done gynecological exams on
MS>their 6th-grade daughters at school without parental permission or
MS>even telling parents such exams were being done as part of a state
MS>policy of requiring all 6th grade students to have physicals.
MS>     According to accounts on other echoes, the girls were not
MS>allowed to call their parents before the exam...nor to refuse it.
MS>Such accounts also said the girls were physically blocked from
MS>leaving the group waiting to be examined.  They also say that a
MS>school-provided advance explanation to parents never mentioned that
MS>the physical would include a gynecological exam, and that the
MS>explanation said that parents' permission was "assumed" if they did
MS>not object in writing in advance.  (Some posts quote articles from
MS>a Pocono, PA newspaper.)
MS>     Is anyone familiar with the incident?
MS>     Does anyone have any opinion on:
MS>          1) Was "informed consent" obtained?
MS>               A kid can't go on a field trip to the museum without
MS>               the school getting a signed permission slip, signed
MS>               by the parent in advance.
        First of all read the statute and see what it says... then.
        "The judicial cases on this subject can be classified into three
types. In ther first, the issue whether the physician has affirmatively
or by silence misrepresented the nature or character of the treatment or
surgery. Such a factual pattern can be characterized as a intentional
tort, either an assault and battery or a fraud." Arthur F. Southwick,
The Law of Hospital and Healthcare Administration.
        Another interesting possibility.
        "If the parent or guardian consents to treatment, but the minor
patient possess both the maturity and understanding and and refuses
consent for the treatment, the physician and the hospital should not
proceed to render care." This is stretching it a little, but since the
treatment is so simple, it might be interesting to raise it.
        "Legally sufficient consent can be classified as either
express or implied in fact. Express consent is manifested by words, oral
or written, while implied consent is manifested by acts on the part of
the patien and by all those circumstances regarding the treatment that
is likely to occur."
        "When physicians or hospitals rely upon oral consent or upon
implied in fact consent, however, two very real related problems of
proof arise. (First is ability to consent..parents obviously qualify).
***"Secondly, even if consent of some sort is established, a further
question is whether the one consenting had a full understanding and
knowledge regarding the nature and extent of the treatment that was, in
fact, rendered."
        "Even when written consent is obtained, subsequent proof by
the patient that he or she lacked the knowledge and understanding of
what in fact took place will negate the consent. Hence one should never
use a written consent purporting in very general language to authorize
the surgeon or doctor to do any procedure deemed necessary as a matter
of professional judgement."
        Another intersting quote:
        "Although her commitment was allowed by state stautute,the
court held the psychiatrist kept the woman from calling an attorney or a
relative his action constituted false imprisonment since her freedom was
unlawfully restrained."  Interesting from both a consent and
incompetency standpoint....
        Misrepresentation: "(I)s another form of tort for which
physicians have been held liable. Misrepresentation is properly
classified as either intentional--that is, fraudulent or decietiful--
or negligent. In both cases it must be shown that a present or past fact
was falsely represented and was relied on by the person claiming injury.
Both ....fall generally into two distinct categories:representations to
induce a patient to undergo treatment and later representations
concerning the treatment or its results."
        Finally, my personal favorite:
        "The intentional tort of outrage, sometimes called the
intentional infliction of emotional distress, arises from extreme and
outrageous behavior by the defendant."
 **MATT:IF YOU PASS THIS ALONG PLEASE MAKE SURE THE FOLLOWING GOES TOO!*
 I am NOT an attorney, not do I play one on tv.  These are just the
 ramblings of a layperson with a law textbook...a VERY dangerous
 combination.(g).
MS>          2) In schools doing at-school physicals, are students
MS>               normally prohibited from calling their parents?
        I would find it hard to believe that kids aren't given
their one phone call(g).
MS>          3) Should the students have been simply given a form for
MS>               their doctors to complete, and told they would be
MS>               suspended if they didn't return it...like with
MS>               vaccinations?
        Yes, in many cases
MS>          4) Are gynecological exams a normal part of at-school
MS>               physicals?
        Don't know.
BTW: Another interesting thing might be who actually gave the physicals
and does it fall under the duties assigned by the appropriate practice
acts??
 * SLMR 2.1a * Typical of today's youth, bringing a knife to a gunfight.
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