DATE: Wednesday, November 12, 1997          TAG: 9711120002

SECTION: LOCAL                   PAGE: B10  EDITION: FINAL 

TYPE: Letter 

                                            LENGTH:   74 lines

LETTERS TO EDITOR -- THE VIRGINIAN-PILOT

PASSMORE CASE

Doctor did his best

within legal constraints

Regarding the case of Thomas Passmore, the young man who amputated his right hand:

Our concerns revolve around the second-guessing of Dr. Tad Grenga, who appeared to respond in a professional manner within the constraints of the present legal system.

Despite following the appropriate legal protocol by obtaining a psychiatric evaluation and consulting with a judge, Dr. Grenga is second-guessed by columnist Ann Sjoerdsma (Perspectives, Sept. 22 and Oct. 20), who suggests physicians should have assumed that the patient was mentally incompetent and proceeded with the operation.

Would Ms. Sjoerdsma assume that every Jehovah's Witness patient who would rather bleed to death than receive a transfusion is mentally incompetent?

There is no question in our minds that appropriate medical therapy was initiated despite Mr. Passmore's psycho-social history and his self-imposed injury.

It is certainly a credit to the jury in this case that they delivered a common-sense verdict for Dr. Grenga after 30 minutes of deliberation. It is unfortunate that he has to undergo criticism on the editorial page after his ordeal within the legal system.

Randolph J. Gould, M.D.

2nd District councillor

Medical Society of Virginia

John T. Kalafsky, M.D., President

Norfolk Academy of Medicine

Steven S. Warde, M.D., President

Virginia Beach Medical Society

Virginia Beach, Oct. 8, 1997

Adult patients can

make their own decisions

I was disappointed to read Ann Sjoerdsma's opinion regarding the outcome of this case. As the lawyer who represented Dr. Tad Grenga in this trial, I would like to provide ``the rest of the story.''

There is no one who is more compassionate in treating patients than Dr. Grenga. From the moment Dr. Grenga saw Mr. Passmore at approximately noon on April 27, 1994, he recommended to Mr. Passmore that the hand be reattached. Mr. Passmore consented to replantation about 1 p.m.

Approximately 90 minutes later, Mr. Passmore changed his mind and declined reattachment. Dr. Grenga was distressed and asked him whether he appreciated the full impact of his decision. Mr. Passmore recited all the risks and benefits that had been explained to him.

Dr. Grenga was not satisfied with the decision. He contacted psychiatry to inquire whether Mr. Passmore's ability to consent had been affected by the administration of various drugs. He was told that the drugs would not affect Passmore's consent. Dr. Grenga then called hospital risk management and asked for assistance. The hospital risk manager told Dr. Grenga to call the judge, who instructed Dr. Grenga that if he proceeded with reattachment against Passmore's wishes, Passmore could sue for criminal assault and battery.

Despite that warning, Dr. Grenga went back to the OR and asked Mr. Passmore, once again, whether he would allow reattachment. When Mr. Passmore declined, Dr. Grenga asked Mr. Passmore what he would do if the hand were reattached against his wishes. Passmore said that he would cut it off again.

Our medical system today requires that each adult patient give consent. It is not for the physician to decide what is right or wrong. To do so would be to play God.

Mr. Passmore made the decision to reject replantation and bears full responsibility for the events that transpired with his amputation. Ms. Sjoerdsma may vote with her ``bleeding'' heart. I am thankful that we had a jury with common sense.

John W. Fitzpatrick

LeClair Ryan attorneys at law

Richmond, Oct. 7, 1997

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