I’ve taught medical misconduct for decades as part of my Torts course, but I’ve never seen anything like it. Dr. Scott Green is charged with appearing in the Supreme Sacramental Court for a traffic violation during an operation. While Green was ready to proceed, the court wasn’t. He must now appear before the Medical Board of California, presumably not in scrubs and in the middle of surgery. While we have discussed cases like a doctor’s hopping over patients in videos in the past, this is the first doctor to act as both surgeon and litigator at the same time.
According to the Sacramento Bee, Dr. Green in an operating room with a patient undergoing a procedure in surgical scrubs.
The clerk says, “Hello, Mr. Green? Hi. Are you available for a trial version? . . . Looks like you’re in an operating room right now? “
“I am, sir,” replied Green. “Yes, I’m in an operating room right now. Yes, I can be tried. Go right ahead.”
The clerk helpfully reminded Green that he and the trial were being streamed live, but it didn’t seem to worry Green, who said he understood but kept working with his head down.
Court Commissioner Gary Link then entered the chamber and disagreed with the idea that Green should split his time and attention between a trial and an operation. However, Green urged the court to proceed, “I have another surgeon here to perform the operation on me so I can stand here and allow them to perform the operation as well.”
The judge refused and Green seems to apologize: “Sometimes an operation doesn’t always work that way …”
Link was supportive and said, “It happens. We want to keep people healthy, we want to keep them alive. This is important,”
It’s not clear if Green tried to say the operation took longer than expected. However, the answer is not to go ahead and try. Green could have asked a member of staff to ask for a delay, or he could have foreseen that he had planned an operation that might conflict with the process. For example, if there had been an unpredictable complication from an operation, it would not only have warranted more time, but also warranted continued attention from Green. If Green was no longer needed in the operation, he could have left. His continued work in the practice showed that he was actually needed. In fact, many procedures dictate two surgeons.
One of the nine basic principles of media ethics is: “When caring for a patient, a doctor must consider responsibility towards the patient as a priority.”
There is also an obligation to put a patient’s interest as a doctor before your own:
The relationship between a patient and a doctor is based on trust, which leads to the ethical responsibility of doctors to put the patient’s wellbeing above self-interest or the doctor’s obligations to others, to make sound medical judgment on behalf of the patient, and to advocate for the well-being of their patients.
The problem for Dr. Green is diverse. First, the most serious consequence is when there have been complications or problems with the patient. Second, there is the potential invasion of the patient’s privacy (even though the patient is not in the camera). Third, there is the obvious problem of medical practice and ethics. When it comes to ethical issues, not only the board of directors but also the hospital must examine the matter. I would be surprised if Green kept his hospital privileges active during the review. While some of the circumstances of the operation need to be determined (such as an unpredictable delay), the key facts are straightforward and obvious. He chose to appear in court during the operation. Most hospitals would disregard the potential liability for the continuation of privileges for a doctor with such a lack of judgment. If he were later involved in any other wrongdoing case (particularly regarding lack of focus or attention), that case would be brought up in court.
The other question is the responsibility of the second surgeon. It may also be a duty of this surgeon to object to a colleague who wishes to file a lawsuit while assisting with an operation. Such reporting is expressly required by the American Medical Association.
What is particularly noticeable is that all legal action is based on evidence obtained from an actual court. In addition, this recording shows that a court is intervening in real time to stop an allegedly unethical act. The courts have long exercised the power to determine what is appropriate in relation to medical practice (and other professional fields), even when such determinations are contrary to long-standing practice. As noted in The TJ Hooper, 60 F.2d 737 (2d Cir. 1932), at the end the courts must say what is required; There are precautions so important that even their general disregard does not excuse their omission. “A court here was not dealing with a long-established practice or custom of multitasking surgeons. However, it was a matter of stopping a practice that was inadequate on the face and involved both appearance as a surgeon and as a trial attorney.