They couldn’t be unaware of the “get the court order” manual

Dr.Diekema said in the Inner Campus interview aired on February 17th that the ethics committee had referred to the American Academy of Pediatrics policy on sterilization of minors with developmental disabilities.

The interview is now available on the program site.

The pertinent part of the policy is found in the footnote #53 on the page 13 of the WPAS Investigative Report. It goes:

When the involved parties believe surgical sterilization to be the best option, application to the courts may provide the only lawful means to accomplish that goal. Physicians and surgeons should be familiar with the law that applies to the jurisdictions where they practice.

American Academy of Pediatrics, Committee on Bioethics, Policy Statement, Sterilization of Minors With Developmental Disabilities, 104 Pediatrics 337, P.13(Aug. 1999), reaffirmed Oct. 2006, 119 Pediatrics 405 (Feb. 2007)

Actually, there is another policy document on sterilization of minors with disabilities, attached to the WPAS Investigative Report. Exhibit E: the WU Medicine Informed Consent Manual (2001-2004).

On the page 3 of the manual, the first section under the subtitle “Limitations on the Authority of Surrogate Decision Makers” goes:

Washington law limits the authority of legally authorized surrogates to consent to certain types of health care or procedures.

1. Sterilization of Mentally Incompetent Person. Legally authorized surrogates may not consent to the sterilization of a mentally incompetent person. Only the patient may provide informed consent for a medical procedure that would result in sterilization. If the patient cannot give informed consent, then a court order authorization must be obtained.

There’s an additional comment at the end of this section which goes:

Specific court authorization is required under Washington law for these procedures. The intent of this limitation is to require court approval before a guardian or other legally authorized surrogate may consent to highly intrusive, irreversible medical treatment that may seriously affect the person’s bodily integrity.

On the oher hand, the doctors explained on the press conference of May 8th, 2007, that the committee had advised the parents to have “court review” but that they later misinterpreted the parents’ lawyer’s guidance as adequate “court review” .

But as we have seen above, the WU Informed Consent Manual clearly states the need of “court order authorization”, “specific court authorization” and “court approval.” Not “court review”, whatever it may mean.

Dr. Gunther was a WU employee. He coudn’t be unaware of this manual.  He was supposed to be familiar and comply with it. Why did they ignore the manual as well as the policy?

I also wonder if “highly intrusive, irreversible medical treatment that may seriously affect the person’s bodily integrity” covers breast bud removal and growth attenuation with high-dose estrogen, too.