421

A full report of our review of the experiences withprobenecid is being prepared for publication, and willbe a follow-up of the preliminary report 2 on this subject.

WILLIAM P. BOGERS. CLYDE STRICKLAND.

Norristown State Hospital,Norristown, Pennsylvania.

2. Boger, W. P., Strickland, S. C. Transactions of the 10th Confer-ence on Chemotherapy of Tuberculosis, 1951. Atlanta ; p. 292.

3. Wolrerhampton Express and Star, Jan. 28, 1954.

Medicine and the Law

Patient’s Consent to OperationA PATIENT suffering from sinus trouble was advised

by her doctor to consult a specialist. Accordingly(" under persuasion," it is said) she went to the RoyalHospital at Wolverhampton. There, she complained,while under the impression that she was being " preparedfor examination," she was given treatment which includedthe piercing of a bone, although she had stipulatedthat she was unwilling to undergo any surgical treatment.She wrote to the Ministry of Health to inquire if it waslegal to give surgical treatment without the patient’sconsent, and if it was customary to direct a patient to thetreatment room without making clear that treatmentwas to be given. She received a reply from the secretaryof the Wolverhamptom hospital management committee.He stated that it was not in order for surgical treatmentto be given without the patient’s consent, but thatconsent could be implied where a patient came to hospitalfor examination. The reply contended that, if a patientcomes to hospital either on doctors’ advice or on his owninitiative, he is deemed to agree to receive treatment.3

In case the matter should be brought before the courtson a claim for damages, no comment can be offered onthe particular facts and allegations at this stage. Everymedical student knows that, as a general principle,a mrgical operation, if performed without the patient’sconsent, is in law an assault for which the surgeon may(ahould the facts be established) be required to paydamages. The consent may be merely oral, but, to savefuture difficulty on the surgeon’s part in proving it, is

usually obtained in writing. An implied consent, if thefacts justify the implication, will suffice ; a patientwho goes to hospital with a broken leg presumablyconsents to it being set ; but the patient in any eventumst understand the nature of the treatment to whichhe is consenting. The allegations in the Wolverhamptoncase were represented to the Minister of Health byllr. J. Simmons, M.p., with a demand for an inquiry.The Minister answered that he was satisfied that nothinghad been. done at the hospital for which the patient’sformal consent should have been obtained. As this

exchange was of a parliamentary rather than a judicialcharacter, Mr. Simmons has been able to express hisdissatisfaction with the result and to voice his convictionthat the Ministry of Health is becoming a medicaldefence society. " Governing bodies of the hospitalsare packed with doctors and matrons, and the interestsof certain classes of patients are unrepresented ; ittecomes impossible to get a thorough investigation intoallegations." An additional element of complaint wasthat the patient had been examined at the hospital inthe presence of another patient ; the conditions whichdenied privacy of examination, said Mr. Simmons, wasanother matter requiring investigation ; this point, heprotested, the Minister had ignored.

Coroner’s Powers over Dangerous ObjectsRecent observations in a coroner’s court have

suggested the revival of the medieval law of deodand-the principle that, if a thing causes the death of a humanbeing, it should be forfeited to appease the divine wrath.

It might be an axe-head which, having left its handle,had killed a man ; it might even be, as the recordsindicate, a horse or a tree which had occasioned a fatalaccident. Deodands were abolished by Act of Parlia-ment in 1846, but what began in primitive folklore maysurvive in modern notions of safety precautions.The recent inquest was an inquiry into a death due to

the dangers of an obsolete gas-fire apparatus. Thecoroner is reported to have said that the apparatus wouldbe confiscated and that he was entitled under theCoroners Acts to refuse to allow it to be returned forfurther use. It is not quite clear how far this power of acoroner extends. The law recognises that a coroner

or his jury may make recommendations designed to

prevent the recurrence of similar fatalities. This is

expressly stated in the Coroners Rules of 1953 whichotherwise restrict the former licence of utterances andriders which might bear upon civil liability. Rule 37seems to be relevant. The gas fire was presumably anexhibit at the inquest. Every such exhibit, according tothe rule

shall, unless a court otherwise directs, be retained by thecoroner until he is satisfied that the exhibit is not likelyto be, or will no longer be, required for the purposes of anyother legal proceedings, and shall then, if a request for itsdelivery has been made by a person appearing to the coronerto be entitled to the possession thereof, be delivered to thatperson, or if no such request has been made, be destroyedor otherwise disposed of, as the coroner thinks fit.If this rule be the authority on which a coroner relies,

it would seem that his power of destruction or disposalis by no means absolute. The Coroners Acts mayjustify the making of rules as to exhibits but not as toforfeiture. If, for example, someone possessing a titleto the apparatus should demand its return so that hecan dispose of it as scrap metal, would not the coronerbe obliged to surrender it ? _

1. Evening Standard, Feb. 11, 1954.

ObituaryHINTON ERNEST BATEMAN

M.R.C.S.

Dr. Hinton Bateman, consulting physician to theelectrotherapy and X-ray departments of York CountyHospital, died on Feb. 9, at the age of 94. He wasalways a man of enterprise and character, and he retaineda wonderful grasp of affairs despite his great age andthe physical infirmities which were a legacy from hispioneer work as radiologist.He was educated at King’s School, Canterbury, and

St. Bartholomew’s Hospital where he qualified in 1882.He began his professional career in York in 1886. Itwas characteristic of his progressive mind that he seizedupon the new science of radiology and set to work withthe apparatus. During the 1914-18 war he workedunceasingly among the wounded at York Military Hos-pital, never sparing himself in his work as radiologist.The unscreened early apparatus damaged his hands,and as a result he had repeated operations and finallyat the age of 91 he had to have an arm amputated.Throughout his life he met all his troubles with admirablecourage and good cheer and seemed fearless of the riskswhich his operations involved.

Dr. Bateman was married twice and had two sons,both of whom died during his life-time. One of them,Dr. Stephen Bateman, was police surgeon for the city ofYork. His second wife survives him.

NORAH KEMPM.B. Glasg.

Dr. Norah Kemp, who was one of the first women toqualify in medicine at Glasgow, died last month at York,where she had practised for 56 years, and where she willlong be remembered for her kindliness and her devotionto her patients.