Ethical Issues in the Charlie Teo Decision (V)
Ian Freckelton1, University Of Melbourne Parkville 1University Of Melbourne, Parkville, Victoria, Australia
Abstract
The July 2023 decision by the New South Wales Medical Council Professional Standards Committee (“the Committee”) in relation to the high profile neurosurgeon, Dr Charlie Teo, engages with a number of important ethical issues in relation to contemporary surgical practice. In particular, it assumes positions in relation to the role of patient autonomy in circumstances where a patient has been given “a devastating diagnosis of impending death”. Its decision that in the circumstances of the risks of surgery far outweighing its benefits, it is the surgeon’s overriding ethical duty to decline to operate, constitutes an important articulation of ethical principle.
Another issue raised by the decision is the extent of the information that a surgeon is obliged to provide to a patient when the consequences of a surgical procedure may be death or serious impairment. Associated with this is the degree of latitude that a surgeon has to depart from the surgical procedure agreed with the patient, when patient autonomy of decision-making must be given proper force.
Further, the decision by the Committee constitutes a rare adoption of an uncompromising position by a regulatory body that the fees charged by a practitioner are excessive in the context of a patient’s vulnerability and the position of unequal bargaining power between the surgeon and the patient. This is a welcome precedent that takes into account the realities of the relevant relationship.
The decision of the Committee is a robust analysis of the expert evidence placed before it, and an acceptance the contemporary need to give weight to the wishes of patients in circumstances where discussion with them as to their options should not be hurried, the stakes are high and time needs to be given to enable reasonable reflection on the surgical and other options that are available to them.
Biography
Ian Freckelton is a King’s Counsel with a national practice throughout Australia. He is a Professor of Law and Professorial Fellow in Psychiatry at the University of Melbourne and an Honorary Professor of Forensic Medicine at Monash University. He is an elected Fellow of the Australian Academy of Health and Medical Sciences, the Australian Academy of Law and the Academy of Social Sciences Australia. He is the Editor of the Journal of Law and Medicine and the author of some 50 books and 750 articles and chapters of books. He was made an Officer of Australia in the 2021 Queen’s Birthday Honours for “distinguished service to the law, and to the legal profession, across fields including health, medicine and technology.”