Informed Consent Sparks Heated Debate
This past January, the Connecticut State Board of Health and Board of Chiropractic Examiners held a series of public hearings on whether there is a need to mandate that chiropractors warn their patients of the risk of stroke prior to performing certain spinal manipulations.
Chiropractors have been adamant that they should not be required to provide patients with information on the risks of stroke prior to performing cervical spine adjustments. During the hearings, chiropractors from many states were brought in to argue that the Board should not mandate informed consent because it unfairly singles out chiropractors. They also argued that they should not be required to warn patients of the risk because there is no credible scientific proof that such a risk is real.
There is, however, a substantial body of scientific literature developed in over sixty years of case studies, and through other medical evidence including autopsy and radiology, confirming the cause and effect relationship between neck adjustments and stroke.
Medical doctors are required to inform their patients of the risks of undergoing their proposed treatment, the risk of foregoing treatment altogether, the benefits and alternatives to their treatment, so that when their patient gives permission for the treatment, their consent is truly informed. . So it is unclear how chiropractors can argue in good conscience that they are being singled out.
Last year, Connecticut state lawmakers attempted to pass a bill that would have required chiropractors receive written informed consent from their patients prior to performing cervical spine adjustments. The consent included a warning of the risk of chiropractic stroke. The bill, however, received strong opposition from state chiropractic groups and never passed.
Should the Connecticut State Board of Chiropractic Examiners vote in favor of informed consent, it will be the first state in the country to have such a requirement and may pave the way for other state boards to follow suit.
Risk of Chiropractic Stroke Real
Chiropractic cervical manipulations cause stroke in a certain number of patients by tearing the lining of either the vertebral or carotid arteries. These blood vessels travel up the neck and supply blood to the brain. When these arteries are torn, blood clots may develop which can break off and flow up into the brain until they lodge into a smaller artery, causing a cessation of fresh blood to that portion of the brain. This tissue dies quickly and can never be replaced. This is called a stroke.
One way the arterial lining can be torn is by rapid rotation motion of the neck, which can occur when a chiropractor improperly performs a neck manipulation. In some cases, chiropractic patients actually have seized and died on the table after receiving one of these neck adjustments in a chiropractor's office. In other cases, patients may not suffer a stroke until hours, days or even weeks after their chiropractic visit.
The true incidence of chiropractic stroke is not known. Estimates range anywhere from one out of every 4.5 million manipulations to one out of every 40,000 manipulations. Several factors make it difficult to determine a more accurate risk level. For example, because chiropractors do not follow-up with their patients progress the way that medical doctors do, they may never know when a stroke occurs. Also, depending on the length of time between the chiropractic visit and the stroke, the patient may not make the connection between the neck manipulation and the stroke. This is in part why advising the chiropractic patient about the risk would enhance patient safety. The patient would be able to advise the physician about the cervical manipulation when they have stroke-like symptoms, then the physician could evaluate the arteries and if there is a tear, preventive measures could be undertaken in time to prevent a full-blown stroke.
Regardless, with the ever increasing number of neck manipulations performed by chiropractors across the country each year, patients have a right to be warned of the risk of stroke, even if it is a small risk. It is the severe nature of the harm that matters most.
However, rather than providing their patients with information about the risk of stroke, many chiropractors fail to tell them anything about the risk at all. Those who do tell their patients often minimize the threat and downplay its seriousness, leaving patients ignorant of a very real, very dangerous hazard to their health.
Contact an Experienced Attorney
Chiropractic stroke can result in death, paralysis and loss of bodily function. Stroke victims may require in-home or nursing home care and may be forced to use feeding tubes in order to live. Chiropractic strokes can forever change a person's life and can result in thousands of dollars in medical treatment and rehabilitation costs.
Chiropractors often insist on being called "doctor" and want to be treated with the same respect as medical doctors. However, they continue to refuse to be held to the same standards of care as MDs, which includes receiving informed consent from their patients before performing any treatment.
If you or a loved one suffered a stroke after receiving a cervical spine adjustment from a chiropractor, contact an experienced attorney today. There is a substantial body of medical evidence proving a causal link between chiropractic cervical spine manipulations and stroke. Chiropractors who fail to warn their patients of this risk should be held legally accountable for their actions.
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Disclaimer: While every effort has been made to ensure the accuracy of this publication, it is not intended to provide legal advice as individual situations will differ and should be discussed with an expert and/or lawyer. For specific technical or legal advice on the information provided and related topics, please contact the author.