Over a period of 12 months, the practitioner caused 37 patient consent forms to be signed by a person other than that patient in respect of surgical operations, procedures or medical treatment. He then knowingly provided to the Alfred Health and/or to the Royal Women’s Hospital those forged consent forms, knowing that they would form part of the patients’ medical record of that hospital.
At the hearing, the practitioner explained that the forms created so much work for himself and his staff that he “decided to cut out the middle man” and simplify the process.
The Tribunal considered the forging of a patient’s signature an extremely serious act for a practitioner to undertake. Firstly, it is a clear breach of the criminal law. Secondly, in forging the signature of the patient, the practitioner had effectively taken away the patient’s ability to exercise an informed consent to the operation.
Although the practitioner said he was confident that he had discussed the matters on the form with all of his patients, the Tribunal considered it was nevertheless an extremely paternalistic approach to patient care for the practitioner to have taken it upon himself to complete the detailed forms on his patients’ behalf, and apparently without their knowledge. It had meant that patients had not had the opportunity to discuss their treatment options and the benefits and risks of the operation in a considered manner with their family or other persons before opting to go ahead with treatment. Further, in forging the patients’ signatures, the practitioner had placed other professionals including his colleagues at great risk. For instance, the forged consent form included consent to anaesthesia. An anaesthetist may well have relied upon such a consent and would have been entitled to do so, not knowing that the consent was forged.
In considering the issue of penalty, the Tribunal noted its concern about the effect of its decision upon the reputation of the medical profession. Patients need to be able to completely trust their doctor, and the forging of a patient’s signature was a complete contradiction to this need for complete candour between doctor and patient. The Tribunal noted it also had a duty to encourage the maintenance of proper ethical and professional standards within the profession.
The Tribunal ultimately decided to impose a 6-month period of suspension of registration, as well as conditions that the practitioner undertake courses designed to educate him as to his responsibilities as a medical practitioner.
To read the decision in Medical Board of Australia v Adams  VCAT 796, click here.