Dr. Charlie Teo had stirred the hornet’s nest of ethical issues by offering to allow a person to spend a day in his company, including the possibility of watching his intricate excision of brain tumours, as a prize in a charity auction held at the Concord Function Centre to raise funds for childhood cancer research. The prize fetched about $1,500.
Attending the function was University of Sydney public health professor Simon Chapman, who has written a scathing critique of the exercise in the British Medical Journal. He wrote, “A person with cancer about to have brain surgery will often be desperate and vulnerable” and might feel unable to refuse a surgeon’s request to have auction winners in the room. He added, “What guarantees are there that a winning bidder would not pass on full descriptions of what they saw to enthralled dinner party guests? What if interesting biographical details slipped out?” How does this respect patient privacy, he asked. He said, “I’m sure Dr Teo has strong views about the people concerned. But I mean bioethics is not down to the person making the call. I mean there are standards, there are arguments, there are ethical principles which need to be considered in the cool light of day. A very obvious other example is in professions particularly for example teachers or doctors, a lot of debate about whether those pupils or patients can consent to have sexual encounters with doctors or teachers. And the answer is plainly no, that they can't even if they say that they wish to consent to do so. But the professions involved there say it doesn’t really matter. It’s irrelevant if the patient consents; that line should not be crossed.”
The executive director of surgical affairs for the Royal Australasian College of Surgeons, John Quinn was worried on a different account – spread of infections. He added, “Surgery’s not a spectacle.” He said even a viewer who did not speak could make doctors or nurses feel self-conscious and behave differently. He explained that the glass-fronted viewing decks, which used to be common alongside operating theatres, had been progressively removed from hospitals as the profession had come to appreciate the ethical problems of informed consent and privacy. Now the college authorities are looking at the matter. “The College does have a code of conduct. There are rules and sanctions,” Dr Quinn said. However when asked if any action could be taken, Dr. Quinn said, “Well the college doesn’t have any authority over hospitals. The public hospitals are under the direction, guidance and control of the health departments in the various states. The college does have a code of conduct which all fellows and trainees in surgery of the College of Surgeons are expected to abide.”
Dr Teo, who operates mainly at Prince of Wales Private Hospital has revealed that he offered similar auction prizes three or four times a year. Winners could stand beside the patient during anaesthesia and recovery, but observed the procedure itself on a screen in the same room, about three or four meters away from the patient. He added that about 10 per cent of patients refused to have spectators and did not personally approach patients but had an assistant offer the consent form.
Dr Teo was made a Member of the Order of Australia (AM) this week for his services to medicine. Most people who won the prize gave it to young family members who were would-be medical students, Dr Teo said, allowing them to see surgery first hand and decide whether to pursue the career.
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