In 1990, Catherine Shine, a life-long asthmatic, suffered a severe asthma attack and was forcibly intubated by Dr. Jose Vega, an emergency physician at Massachusetts General Hospital. The intubation was performed without Ms. Shine's consent and over her repeated and vigorous objections, as well as the objections of her father, Dr. Ian Shine, a physician who was in touch with the Dr. Vega by telephone. In July, 1992, Catherine suffered another severe asthma attack. In this instance, she refused to go to a hospital because, it was claimed, she had developed an intense fear of hospitals. She eventually lost consciousness and died two days later. In 1993, Dr. Shine brought a complaint against Dr. Vega and the hospital seeking damages for tortious conduct and the wrongful death of his daughter. He alleged that Catherine was traumatized by her experience at Massachusetts General's emergency room, and that Ms. Shine''s delay in seeking medical treatment was a substantial factor in causing her death.
At trial the hospital and Dr. Vega maintained that a physician confronted with a life-threatening emergency is not required to obtain consent for treatment from either the patient or her family. The trial judge agreed, repeatedly instructing that jury that no patient has a right to refuse medical treatment in a life-threatening situation and that in an emergency the physician need not obtain the consent of the patient or her family to proceed with invasive treatment. A jury returned verdicts for the defendants on all counts. Dr. Shine appealed, contending that the trial judge incorrectly instructed the jury concerning a patient's rights in a life-threatening emergency.
The Supreme Judicial Court of Massachusetts rules that the trial judge's instructions were erroneous and that the errors were prejudicial, and remands the case for a new trial. The court holds that the emergency exception to the informed consent doctrine comes into play only when the patient is incapable of consenting and failing to treat would result in imminent harm. "The privilege does not and cannot override the refusal of treatment by a patient who is capable of providing consent," the court writes. "If the patient is competent, an emergency physician must obtain her consent before providing treatment, even if the physician is persuaded that, without the treatment, the patient's life is threatened. . . If the patient's consent cannot be obtained . . . the emergency physician should seek the consent of a family member if time and circumstances permit."
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