O&G faces suspension and criminal charges after forging patient consent forms

Seeking a patient’s informed consent is not simply about getting a signature on a form. It is a process of doctor and patient reaching a mutual understanding and shared decision about treatment. Treating consent as an unnecessary bureaucratic requirement is not only poor patient care, it can also have significant legal and professional consequences. 

Dr T, an obstetrician and gynaecologist, operated at a regional hospital, as well as other locations. A hospital investigation was launched after it came to their attention that some patients had not signed the consent forms contained in their medical records. 

Dr T admitted having forged signatures of 37 patients on consent forms for surgical procedures or medical treatments over a one-year period.  

Dr T said he had become frustrated with the administrative burden imposed by the hospital’s new elective surgery admission forms. These had become significantly longer, more complex and difficult for patients to complete.  

For many of his patients, English was their second language and they had difficulty completing the forms. Also, long public waiting lists meant patients’ conditions had often changed by the time they came to have surgery and they needed a different procedure. 

As a result, Dr T considered it was a waste of time to go through a long form with an interpreter if the patient was not likely to undergo that specific procedure by the time it came to their hospital admission.  

Dr T raised his concerns with hospital administration who initially agreed his patient could be admitted under the initial consent form signed at the time of booking, but then was told the new form was mandatory. 

He believed the patients would sign a new consent form on admission to hospital and his consent forms were unnecessary duplication. So he completed them himself. 

The tribunal concluded, and Dr T conceded, that his conduct amounted to professional misconduct. 

Although each patient had had a satisfactory outcome, falsifying the documents was a crime and there had been a deliberate pattern of fraudulent conduct over a long period. It was a clear violation of the trust at the core of the doctor-patient relationship.  

Dr T claimed to have discussed the procedures in detail with all patients, including any potential complications. However, Dr T’s records were often cursory notes such as ‘operation discussed’. These provided very little evidence of what he had told patients about the procedure.  

The tribunal noted that even if detailed discussion had occurred, filling in the forms without patients’ knowledge denied them the opportunity to reflect on the procedure or discuss it with family or others before deciding to proceed. 

Dr T had provided the forged forms to the hospital and they were included in the patients’ medical records and relied on by other healthcare professionals. The tribunal was highly critical that Dr T had placed other medical professionals at risk as the consent forms also covered their treatment of the patients and would have been relied upon to provide other services such as anaesthesia, blood transfusions and the removal of tissue.  

The tribunal accepted that Dr T had admitted the conduct and shown remorse.  

However, it concluded that he still lacked insight that the consent process was not purely a bureaucratic requirement, but was ‘required to fulfil the doctor’s obligation to involve patients fully in decisions of a critical nature concerning their care.’ It also noted the length of time and deliberate nature of the conduct. 

These factors, and need to protect public trust in the profession, required a significant penalty. 

Dr T’s registration suspended for 6 months. He was also required to undertake one-one-one education about informed consent.  

Dr T also faced criminal charges of falsifying documents. He was found guilty but with no finding of guilt recorded. 

Consent is a process, not an administrative exercise. At its core, it requires reaching a mutual understanding and shared decision about the patient’s treatment. 

Patients have a right to participate in decisions about their treatment, including the opportunity for discussion and to ask questions. Patients must give their consent freely. 

Documenting the consent process is important and should reflect the discussion between doctor and patient. It should not be focused on the signed consent form even if you’re required to use a particular form for certain procedures or in your facility or hospital.  

Avant factsheet: Consent-the essentials 

Avant eLearning: Informed consent and more 

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