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Doctor's use of unnecessary stents raises question of informed consent

Your article about the Physician's Board revoking Dr. Mark Midei's license to practice neglected to mention the question of whether he obtained his patients' informed consent ("Cardiologist's license revoked for unnecessary stent operations," July 14).

The story reported the board found that Dr. Midei had "inserted cardiac stents into arteries that weren't clogged enough to need them." The question is, did he have the patient's informed consent before proceeding with treatment?

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The "Doctrine of Informed Consent," which is part of the Maryland Constitution, imposes on health providers the duty to inform a patient of any information that a practitioner "knows or ought to know would be significant to a reasonable person in the patient's position in deciding whether or not to submit to a particular medical treatment or procedure."

Further, the duty to disclose requires a provider to reveal to the patient the nature of his or her illness, the nature of the proposed treatment, the probability of success of the therapy being contemplated and the risks associated with the treatment.

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It is unfortunate that Maryland citizens too often are under-informed regarding their rights when undergoing medical or dental treatment. The law does not allow a physician or dentist to substitute his judgment for that of the patient in matters of consent, no matter how well-founded the practitioner's opinion may be.

Albert Bedell

The writer is executive director of the Alliance for Integrative Health Care, a Maryland-based health advocacy group.

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