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A court ruling handed down earlier this month on a botched operation at a hospital affiliated with the Jikei School of Medicine sheds light on the lack of ethics among some doctors. The operation led to the patient’s death a month later.

The Tokyo District Court determined that three surgeons at Aoto Hospital in Tokyo did not have the minimum skills required for the operation and did not bother to control the bleeding. The court gave the doctors suspended sentences, since actual prison terms would have been unfair in view of the irresponsibility demonstrated by their supervisors. This ruling should remind doctors and hospital officials of the heavy responsibility they bear toward the lives of their patients.

The background of the case is appalling. The Nov. 8, 2002, operation on a 60-year-old prostate cancer patient required only a few incisions. But it was the first operation in which the three surgeons used a laparoscope — a tube with a light and a camera lens. Unsure of what to do, they ended up consulting a manual during the operation and even phoning the maker of the device for help. The surgeons damaged veins near the prostate gland, causing massive blood loss, which led to brain death.

The doctors had not told the patient that the operation was risky. Supervisors approved the operation, knowing that the surgeons lacked the required skills. The court saw no urgent necessity to have adopted that particular type of operation at the time and said the surgeons appeared to put their desire for practical experience ahead of their patient’s welfare.

The Japan Council for Quality Health Care reports that last year there were 1,114 serious incidents at some 270 major hospitals across the nation, resulting in 143 deaths. Doctors and hospitals need to scrutinize their basic attitude toward their job and their procedures, including the method of obtaining informed consent from patients. High-quality medical treatment is feasible only if it is backed by sterling ethical standards.

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