Singapore

Gynaecologist suspended, fined for removing patient's ovary without consent

Gynaecologist suspended eight months, fined $10,000

Dismissing a gynaecologist's appeal against his suspension for professional misconduct, the Court of Three Judges made clear that producing a "mere signed piece of paper" was not enough to show there was informed consent from a patient scheduled to undergo surgery.

It said the consent form she signed was not relevant unless and until it was proven she had understood the exact nature of the operation she was to undergo.

The 34-year-old patient had made a complaint against Dr Jen Shek Wei, 62, for removing her left ovary without her informed consent in an operation in 2010.

He also based his advice to her to have surgery on a scan without doing necessary further evaluation.

Dr Jen was held guilty of both charges by a Singapore Medical Council disciplinary tribunal (DT) last year. He appealed to the Court of Three Judges in July.

The court raised the issue of informed consent "as a general point of practical significance to the medical profession", on Tuesday as it affirmed the SMC tribunal's decision to suspend Dr Jen for eight months and fine him $10,000.

He had also to undertake in writing not to repeat the conduct.

The court, comprising Judges of Appeal Andrew Phang, Judith Prakash and Steven Chong, said his conduct justified a deterrent sentence.

PELVIC MASS

Dr Jen, who has been in practice for 28 years, had advised the patient to undergo surgery to remove a pelvic mass discovered during a scan without carrying out any further assessment of her condition.

Then, in the operation on Aug 21, 2010, to excise the mass, he instead removed her left ovary.

He did so without her informed consent, which breached SMC's Ethical Code and Ethical Guidelines. The patient, a finance manager, only found out later when she saw another doctor.

Dr Jen's lawyers, led by Senior Counsel N. Sreenivasan and Mr Charles Lin, argued the DT's finding had erred in believing the patient's version of events.

The court was not convinced and found, among other things, that informed consent had not been obtained to remove the ovary.

The court said the consent form alone that she had signed was "irrelevant" as she had not understood the implications of the surgery.

"The form is, at best, an indicator (and no more) that the obligation had been discharged but it is not conclusive as a defence to a charge of failing to take informed consent," wrote Justice Phang.

The court found Dr Jen's version of the events "implausible" and said his indifference to his patient's welfare and his lack of remorse were aggravating factors.

The tribunal's punishment of an eight-month suspension was on the low side, as it could have been 16 months instead, the Court said.

Nonetheless, it retained the sentence, ordering the suspension to start in a month's time.

COURT & CRIME