Rectal Exam Lawsuit

[Dr. Dukes]

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Not sure if this has been discussed here already, if so I apologize for my bad searching skills.
A couple of weeks ago a New York Times blod (http://cityroom.blogs.nytimes.com/2008/01/16/forced-rectal-exam-stirs-ethics-questions/) posted a story about a lawsuit against New York Presbyterian (Cornell's major teaching hospital). The blog has more details, but long story short: a guy came into the ER with a head laceration from getting hit in the head with a piece of wood that ended up requiring stitches. In the course of the ED's evaluation of this patient (construction worker maybe brought in by ambulance, maybe came in by himself) a resident tried to give the patient a rectal exam, which he refused. The resident tried, again, he refused again (a little more adamantly this time...). Fast forward a couple of minutes, and the patient is actively resisting the rectal exam and punches the resident. He was then intubated and the evaluation was completed.
When he woke up he was arrested for assault, and the charges were later dropped.
He's now suing the hospital saying he has PSTD from the whole event.
My question to those of you who know more than I do (MSI and EMT-I): was the rectal necessary? As I understand it, a combative patient is an AMS patient, therefore he can't refuse treatment cause he isn't competent to make his own decisions.
Thought?

Also, some of the comments on the blog are pretty interesting in their own right...

 

[sleepymed]

hey, this has been talked about quite a bit... here's a link to the discussion:

http://forums.studentdoctor.net/showthread.php?t=487498

😀😀

 

[sleepymed]

hey, this has been talked about quite a bit... here's a link to the discussion:

http://forums.studentdoctor.net/showthread.php?t=487498

😀😀

"The doctors should be in jail for rape, sexual assault, and put on the sex offenders list. The wrong person was arrested.
— Posted by Ann"

Does this turn anyone else on??? it's getting mighty hot over here!

 

[Dr. Dukes]

I suppose a more thorough search would have been good, but in my defense this is my first time here since I started school back in August. A friend just sent me that link and I wanted to take a break from memorizing Amino Acid degradation pathways.
On another note, some of the comments on the forum are priceless...I personally love #138:

rectal exam
This examination may be used:
1. for the diagnosis of rectal tumors and other forms of cancer;
2. in males, for the diagnosis of prostatic disorders, notably tumors and benign prostatic hyperplasia;
3. for the diagnosis of appendicitis or other examples of an acute abdomen (i.e. acute abdominal symptoms indicating a serious underlying disease);
4. for the estimation of the tonicity of the anal sphincter, which may be useful in case of fecal incontinence or neurologic diseases;
5. in females, for gynecological palpations of internal organs
6. for examination of the hardness and color of the feces (ie. in cases of constipation, and fecal impaction);
7.prior to a colonoscopy or proctoscopy.
to evaluate haemorrhoids
Hum, for some reason spinal injury is “NOT” listed.
— Posted by Doc™-

I added the bold to neurological disease...surely having your neurological conduction severed (spinal cord injury) would fall under the category of disease...

 

[EM_Rebuilder]

I suppose a more thorough search would have been good, but in my defense this is my first time here since I started school back in August. A friend just sent me that link and I wanted to take a break from memorizing Amino Acid degradation pathways.
On another note, some of the comments on the forum are priceless...I personally love #138:



I added the bold to neurological disease...surely having your neurological conduction severed (spinal cord injury) would fall under the category of disease...

Yes and no... I dont know about the particulars, but personally I consider a disease/syndrome to be more of a chronic/physiologic type thing.... there is that, then there is 'trauma/injury'.... getting your arm broken is not a 'disease' nor is 'breaking your back and severing you spinal cord'.... guillain-barre would be a disease/syndrome...

 

[Leukocyte]

If you have not seen this yet, you MUST see it:


http://www.youtube.com/watch?v=mSiBecCRymE

[YOUTUBE]Family Guy-Peters Prostate Exam [/YOUTUBE]

 

[EM_Rebuilder]

If you have not seen this yet, you MUST see it:


http://www.youtube.com/watch?v=mSiBecCRymE

[YOUTUBE]Family Guy-Peters Prostate Exam [/YOUTUBE]

hahaha