Anesthetist gave woman morphine without her consent – Health and Disability Commissioner
The Deputy Commissioner for Health and Disability discovered that an anesthetist had administered morphine to a woman without her consent. Photo/NZME.
An anesthesiologist has been criticized for giving a woman morphine without her consent.
“It is unacceptable that the anesthesiologist did not discuss with the woman the possibility of a morphine trial during the operation, nor obtain her consent to this,” said the Deputy Commissioner for Health and Disability , Deborah James.
James concluded that the anesthetist breached the Health Services Consumers and Disabilities Code of Rights.
She said it was particularly important given that the woman had previously expressed concerns about the drug.
“The woman was particularly vulnerable, as she was under anesthesia. I criticize the actions of the anesthesiologist for giving the woman morphine when she had not consented to the lawsuit,” James said.
Before the operation, the woman told the anesthesiologist and Te Whatu Ora about her concerns about the morphine.
There was documented evidence of the patient’s past adverse reactions to morphine in clinical notes, as well as on her medical emergency bracelet.
The woman said the morphine could slow her heart rate to an abnormally low rate.
However, the anesthetist gave the woman 3 mg of morphine.
He thought it would help control his pain after surgery. He also believed that the small dose and constant monitoring would allow him to determine if it was a safe drug for women.
The woman never gave her consent to the anesthetist to do so, which James says needs to be in writing.
If general anesthesia is administered, the Code of Rights for Consumers of Health and Disability Services states that consent must be given in writing as a protective measure.
After the operation, the woman was told that she had been given morphine.
James found that Te Whatu Ora did not violate the Code, as the errors that occurred did not indicate broader systems issues and appropriate policies had been in place.
However, James said Te Whatu Ora staff could have done more to advocate for the woman to prevent the use of morphine without her consent.
She recommended that the anesthetist undertake further education and training on informed consent and report to the Health and Disability Commissioner at the end of the training.
She also recommended that Te Whatu Ora use an anonymized version of this case for the education of its staff.
James said the process for pre-op checks could be streamlined and steps would be taken to ensure staff can advocate for patients in theater when and as needed.