Consent

[telima]

What is the name of your state?Pennsylvania
I have read a lot on your board about patients signing consent for various procedures. I have a basic question. I had to have emergency surgery for an above the knee amputation. I now have phantom pain. There was nothing in consent form about phantom pain that I signed. I have found out during the aftermath that there are things that can be done post surgery to keep phantom pain from occuring. I have suffered greatly. Is the surgeon responsible or could he be held responsible for not educating me or asking my consent before doing the surgery or for not taking any actions to prevent it? I thank you in advance for your help in this matter and for having a forum such as this, what a great service you offer.

 

[BelizeBreeze]

What is the name of your state?Pennsylvania
I have read a lot on your board about patients signing consent for various procedures. I have a basic question. I had to have emergency surgery for an above the knee amputation. I now have phantom pain. There was nothing in consent form about phantom pain that I signed. I have found out during the aftermath that there are things that can be done post surgery to keep phantom pain from occuring. I have suffered greatly. Is the surgeon responsible or could he be held responsible for not educating me or asking my consent before doing the surgery or for not taking any actions to prevent it? I thank you in advance for your help in this matter and for having a forum such as this, what a great service you offer.

The conset form is for the surgery. Although most good doctors do discuss all variables that can occur during and after surgery, here is no provision in law that REQUIRES them to inform you of everything that COULD happen.

Phantom pain happens. It's not a given but can occur.

 

[ellencee]

telima
Phantom pain is not a risk and it does not have to be explained before surgery. Emergency surgery does not require the same explanation and understanding of risks of a non-emergency procedure. I can't think of any surgeons who routinely mention phantom pain.

Before I attempt to briefly explain phantom pain, let me explain consents. A consent does not cover acts of negligence that result in significant damages; it is not legal permission to allow the surgeon to perform below the minimum standard of care.

And, let me tell you about the requirements to explain the risks of surgery--many essentially simple surgical procedures have over 260 potential and known risks! It is impossible to list all of the potential and known risks of surgery and expect anyone to understand the risks and accept the risks; therefore, surgeons only have the duty to explain the more common risks and must include the risk of death. (A 2% risk does not have to be explained, in most circumstances and most surgeries).

Phantom pain can be treated, though it may persist. There is no way of knowing which patients will gain immediate and permanent relief, which will have bouts of pain that can be managed, and which will develop intractable pain.

Your leg was amputated, but the nerves that "felt the pain" in your toes, foot, and leg still exists; the nerves are just shorter on the distal end (away from your spinal cord). Going towards your spinal cord, the nerves that felt your toes, foot, and leg still connect through the spinal cord to the part of the brain that ONLY received "feelings" from your toes, foot, and leg that are now missing. Thus, when the nerves "feel" pain and send the message to your brain, your brain tells you that your leg hurts, or your foot hurts, or your toes hurt. That section of your brain does not know the nerves end at the point of the amputation; therefore you feel your missing leg, foot, and toes.

Treatment for phantom pain is often a nerve block to stop the nerve from connecting to the part of the brain that feels the missing parts. Give yourself and your body a chance to adjust to the changes and give pain management a sincere effort.

Best wishes,
EC

 

[telima]

Reply

Thank you for taking the time to answer my query. I had not considered just how many risks for even simple surgery that there were. I appreciate you taking the time to help me understand and have a feeling of easiness about it all that I did not have before. I wish you well also.
Sincerely, telima

 

[howamidoing]

telima
Phantom pain is not a risk and it does not have to be explained before surgery. Emergency surgery does not require the same explanation and understanding of risks of a non-emergency procedure. I can't think of any surgeons who routinely mention phantom pain.

Before I attempt to briefly explain phantom pain, let me explain consents. A consent does not cover acts of negligence that result in significant damages; it is not legal permission to allow the surgeon to perform below the minimum standard of care.

And, let me tell you about the requirements to explain the risks of surgery--many essentially simple surgical procedures have over 260 potential and known risks! It is impossible to list all of the potential and known risks of surgery and expect anyone to understand the risks and accept the risks; therefore, surgeons only have the duty to explain the more common risks and must include the risk of death. (A 2% risk does not have to be explained, in most circumstances and most surgeries).

Phantom pain can be treated, though it may persist. There is no way of knowing which patients will gain immediate and permanent relief, which will have bouts of pain that can be managed, and which will develop intractable pain.

Your leg was amputated, but the nerves that "felt the pain" in your toes, foot, and leg still exists; the nerves are just shorter on the distal end (away from your spinal cord). Going towards your spinal cord, the nerves that felt your toes, foot, and leg still connect through the spinal cord to the part of the brain that ONLY received "feelings" from your toes, foot, and leg that are now missing. Thus, when the nerves "feel" pain and send the message to your brain, your brain tells you that your leg hurts, or your foot hurts, or your toes hurt. That section of your brain does not know the nerves end at the point of the amputation; therefore you feel your missing leg, foot, and toes.

Treatment for phantom pain is often a nerve block to stop the nerve from connecting to the part of the brain that feels the missing parts. Give yourself and your body a chance to adjust to the changes and give pain management a sincere effort.

Best wishes,
EC

Utterly Fasinating....Thank you for elaborating on that. I myself was curious .