Tuesday, November 11, 2014

Sign on the Dotted Line, Please

The dotted (or perhaps not) line has become the place where we are constantly asked to affix our signature attesting to the fact that we are agreeing with all that appears above it. Do we carefully review all that text and do we know that we can make changes to it before signing? How many times have you signed where directed, never read the document and didn't request a copy for your files? I will bet you've done it more than you care to admit.

The tragic death of Joan Rivers is one sad illustration regarding forms used to permit a medical procedure. But the one thing that apparently was missing when the procedure actually went ahead was that someone failed to follow the specifics of the signed form. There was limited permission given for a very specific procedure and nothing else was to have been performed.

The media are reporting that additional medical probing was done and a biopsy may have been attempted. The current investigative findings include unauthorized procedures, unauthorized personnel performing the procedures and a number of either contradictory actions or a lapse in protocols prior to sedating patients. The legal process will sort out this particular case, but it is instructive for all of us.

Healthcare providers utilize a variety of forms prior to any evaluations or treatments and this provides some degree of protection for the patient as well as the healthcare professional and the facility where the procedure is to be initiated. Within the many paragraphs of text are a few items that most patients gloss over and never notice. Hospital admissions, in particular, may be unnerving tests of your resolve to do everything with complete care. Among the forms to be signed will, assuredly, be some form of permission given to do whatever without first asking, once again, for permission. You've given them carte blanche.

Are you aware that when you sign one of the permission documents for evaluation or treatment that there are rights you have signed away? One of the rights is privacy where you agree that the professional may video, take specimens or other materials and use these for research, training or presentations. With your signature on that bottom line, you may find your case appearing in a journal, book or video presentation on YouTube.

You can, if you wish, cross out this section, affix your initials to it and date the deleted section. This should maintain your rights, but if you are fully sedated, how do you know what will happen? In the case of Joan Rivers, we hear, someone in the room began to take cell phone photos. It may or may not be true. We leave that to the attorneys.

Some forms may indicate that you've relinquished your rights to your intellectual property (photos, videos or text) once you upload it to someone's server.  This permission is often on internet sites and you "approve" or "agree" with that little check mark and then login to the site. You've just bought the farm.

In the case of photos, you can go into the metadata and place your name and copyright information. Even this bit of privacy protection isn't as robust as we'd like and the data doesn't migrate if someone were to do a screen grab or copy the image from the web. Watermarks might help, but they distort the image when it appears in any format. You can remove it, if the potential user notifies you of their interest in your photo or video. Text, on the other hand, is totally at risk except when it is copied and pasted from certain Internet sites because the underlying html may go along with it. But even here there are ways to cadge the copy and get around the html protection that tries to stop your right-click-save-as move.

How many rights have you signed away when you complied with that simple request to "Sign here, please." You'll never know unless you begin carefully reading the text above your valuable signature and amending it as you wish. You never need to give absolute 100% permission to use anything.