When do you have the right to say “NO” in the ER?
Elizabeth
State: Rhode Island
Congressional District: RI01
Diseases
Issues and Challenges
Elizabeth has encountered: Abuse (Mental, Physical, Elder), Discrimination (nonmedical), Gaslighting, Involuntary Hospitalization / Commitment
My Story
Yesterday, I got into a verbal altercation with staff at the Hasbro ED in Providence, Rhode Island. I had taken my 11 month daughter in for x-rays after a fall had left her unable to put weight on her right leg. It turned out that she had two buckle fractures: one in her tibia, and one in her fibula. We were given a room and told that the orthopedics would come down and put a cast on.
Two or three hours later, a doctor came into the room and told me, "We need to do a full evaluation."
"Of her leg?"
"No, her full body. We need you to undress her, and we need to check everything."
When I asked why that was suddenly necessary, she gave a one-word answer: "Policy."
I told her I wasn't consenting to any examinations that were not medically relevant. She insisted that it was "very relevant" and "not an option," yet she continued to offer no justification whatsoever of its necessity. I told her that I expected her to adhere to the standard of Informed Consent, and that she had neither Informed me, nor I Consented.
At that point, she began saying that I needed to take my daughter in for additional x-rays. The language she used included "need," "have to," "not an option," and "no way you're not doing this."
Again, she offered no justification beyond that one word: "Policy."
Upon arrival at Triage, my daughter's leg had been evaluated, and x-rays had been taken. The tibia and fibula fractures had been identified, and I had been told that an orthopedic would be down shortly to put on a cast. My daughter was in perfect health other than the break. Aside from a 5mm bruise on her shin, there was not a single mark on her body---including at the site of her compression fractures. She was a calm, happy baby displaying every sign of secure attachment and emotional stability.
It wasn't until I had asked directly, multiple times, that the doctor disclosed the nature of the "non-optional," "necessary" x-rays that "Policy" requires "everyone" to do. Apparently, the prescribed imaging would involve 10 additional x-rays, collectively digitizing "her whole body"---at my expense, and to the financial benefit of the hospital. Oh, and one more detail: My baby would have to be be naked, sitting in the lap of a stranger.
I told them that the x-rays didn't make sense. They seemed "irrelevant," "unnecessary," "unjustified," and "extraneous," not to mention utterly exploitative. I did not consent. I reminded her that I had come to the hospital for the purpose of treating my daughter's broken leg, and I asked that the orthopedic come in and put on a cast.
The doctor responded by telling me that there was "no way" they would put a cast on my daughter unless I consented to the 10 extraneous, naked x-rays. Again, the only justification was, "Policy."
At this point, a security guard was brought in to shadow me. He ended up sitting outside my door for the remaining 4.5 hours (8 total) of my imprisonment.
I told the doctor that I didn't feel comfortable receiving care from the Hasbro hospital under these conditions, and I asked where else I could go to get a cast for my daughter. The doctor told me that if I attempted to leave the hospital without a cast, that she would call the police and have me arrested.
By the transitive property... if I did not consent to 10 extraneous naked x-rays, without any medical justification whatsoever, at my expense---or if I sought medical assistance elsewhere---the hospital staff would have me arrested.
I reminded the doctor that she had no right to detain me. The hospital was not a prison, she was not a jailer, and I had not committed any crime (nor, as explained above, was there any reason to believe I had). I reminded her that she was not authorized to force me to do anything against my will, and that the standard of medical care is Informed Consent. Her response? "There's no way I'm letting you leave this hospital without the x-rays."
Under extreme duress, I consented to the original irrelevant, invasive demand: A full exam of my daughter's body. I woke her up from a nap, undressed her, and watched as the bully-doctor used gloved forefingers to split her outer and inner labia. At the discovery that my daughter was in perfect health, with no signs of trauma whatsoever, the doctor became mute with surprise (or was it disappointment?). The next time she spoke, it was in sentence fragments. Something about how she hadn't believed me that my daughter, who was only 11 months, could walk, and "it would really help" if I could offer a photo or video as proof.
Unfortunately, experiences like this are common. Medical staff are trained to use words like "going to," "need to," and "have to" instead of "My recommendation is...," and, "Let me know what you decide..." When patients decline to follow orders, they are met with suspicion. The evident thought process is as follows: Either this person is uneducated (in which case, I must lecture her about "the importance of your child's safety"), or she has something to hide (in which case, it is morally praiseworthy to issue actual, legal threats). In each dispute, there is an obvious conflict of interest. The hospital, which has usurped Supreme Authority, also stands to benefit financially.
The conclusion of my story is that my daughter never got the x-rays (as it turns out, they weren't necessary after all, and the hospital was unable to force me to do them), my daughter eventually got a cast, and I got 8 hours' worth of intense psychological trauma. There will be no repercussions for anyone on staff at the hospital, and Hasbro will continue to improve its bottom line by bullying patients into thousands of dollars' worth of unnecessary procedures.
When I got home at 9:00 at night, every muscle in my body tense, I had a surprise visitor. The DCYF agent told me that a case had been opened against me, but not to worry. He had already investigated and found that the accusations were "completely unfounded."
My Motivation and Inspiration
I'm tired of a system where doctors believe they have the right to force their will on patients, without informed consent, at the patient's expense.
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