Woman 'pressured' into having ovaries removed

The woman's obstetrician and gynaecologist have been found to be in breach of the Code of Health and Disability Services Consumers' Rights. Photo / Thinkstock

A woman says she felt "immensely pressured" when she gave her consent to having her ovaries removed while at the operating table.

In a written report released today, Health and Disability Commissioner Anthony Hill said the woman's obstetrician and gynaecologist were in breach of the Code of Health and Disability Services Consumers' Rights, for failing to obtain informed consent before removing the woman's ovaries.

In November 2011, the woman, who had a history of epilepsy and menstrual problems, had an ultrasound at the gynaecology clinic of a public hospital.

Here she was diagnosed with adenomyosis, the treatment for which was a hysterectomy, however, the woman chose not to undergo this surgery.

In December 2012, the woman was once again seen at the gynaecology clinic by an obstetrician and gynaecologist.

The doctor explained adenomyosis to her, and recorded that the woman had decided to undergo a hysterectomy.

She then signed a consent form for a "total abdominal hysterectomy".

During the same consultation, the the woman was diagnosed with catamenial epilepsy, which is a subset of epilepsy where a woman's seizures are made worse by her menstrual cycle.

The woman recalled the doctor discussing with her the relationship between her seizures and her menstrual cycle, but said that she was not told that she had been diagnosed with catamenial epilepsy.

The surgery took place approximately four months later.Immediately before the procedure, while the woman was on the operating table, the doctor approached her and sought her consent to the removal of her ovaries.

The woman said despite feeling alone, distraught, and "immensely pressured" to make a major life-changing decision, she signed her consent to have her ovaries removed.

Mr Hill found that the manner in which the woman's consent was obtained for the removal of her ovaries was not appropriate.

"In my view, the operating theatre was not an appropriate environment for the doctor to provide information to the woman about the proposed removal of her ovaries and to seek her consent to that procedure, in that it did not allow for effective communication between the parties."

He found the woman was not given sufficient time to consider whether she wished to have her ovaries removed, and was not in a position to give informed consent for the procedure.

Mr Hill was also critical that the doctor did not appear to have communicated clearly to the woman that he had diagnosed her with catamenial epilepsy.The doctor has since apologised to the woman.

Mr Hill also recommended that the gynaecologist undertake further training on informed consent processes.

Although the DHB was not found in breach, Mr Hill recommended that it review staff training with regard to its informed consent policy, provide the Health and Disability Commissioner with the outcome of its audit of consents for abdominal hysterectomy, and that it audit compliance with the requirement that a definitive plan regarding ovarian conservation or removal is documented at the time a patient consents to a hysterectomy.