Let me clarify that the parents, through an interpreter, had consented
to enucleation. I may be benighted but I'm not crazy!
The issue is what to do regarding the child's assent. My conflict was
whether to stop the eight things I was doing in order
to allow the child to understand the procedure before the surgery. This
is of course knowing that a delay in the procedure may
adversely affect the possibility of salvaging the eye. I acknowledge
that it isn't supposed to matter, but the patient
had no insurance, no primary provider, and it was a Saturday, meaning I
had no readily available social worker. I would have
had to stop the entire ER (at about 6 patients per hour), and get
obstructive with the only opthalmologist that I had available.
Okay, now you may cast your stones.
Jay Fisher MD
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