8. Conduct the official correspondence of the colony, and keep a record or copy of all letters written by himself and by his clerks and agents, and files of all letters received by him or them. 9. Prepare and present to the board, at its annual meeting, a true and perfect inventory of all the personal property and effects belonging to the colony, and account, when required by the board. for the careful keeping and economical use of all furniture, stores and other articles furnished for the colony. 10. Keep a record of all applications for admission of patients, and enter in a book to be provided and kept for that purpose, at the time of the admission of each patient to the colony, a minute, with the date, name, residence of the patient, and of the persons on whose application he is received, with a copy of the application, statement, certificate and all other papers received relating to such epileptic patient, the originals of which he shall file and carefully preserve, and certified copies whereof he shall forthwith transmit to the state board of charities. 11. Have power, subject to the supervision and control of the board of managers, in case of the death of any patient at such institution who shall have been maintained therein wholly at public expense, to make or cause to be made at the said Craig Colony by a member or members of its medical staff an autopsy on the body of such patient, provided that such autopsy be made in such manner as will cause the least possible mutilation, and provided also that the said Craig Colony shall print conspicuously upon all application blanks used in admitting patients to the institution the fact that the officers of said colony have the above stated powers in relation to the making of autopsies (As amended by chapter 40 of the Laws of 1914.) (As amended by chapter 449 of the Laws of 1910.) Superintendent has the right to perform surgical operations when necessary. No right to make autopsy without consent of relatives or persons entitled to the body. STATE OF NEW YORK, ROBERT W. HEBBERD, Esq., Secretary State Board of Charities, Albany, N. Y.: DEAR SIR.I beg to acknowledge the receipt of your letter of the 19th inst., in which you request my opinion upon the following questions: 1. The authority, if any, possessed by the Superintendent of the Craig Colony to retain patients and if necessary to deprive them of their liberty. 2. The authority, if any, possessed by the Superintendent of Craig Colony to undertake and perform any surgical operation upon any patient of the colony, if such operation be, in the Superintendent's opinion, of so serious a nature as to jeopardize the life of the patient. 3. The authority, if any, possessed by the Superintendent of Craig Colony to hold an autopsy upon a patient without first obtaining the consent of the friends or relatives of the patient before so doing. Permit me to say that your first question was answered by my predecessor, which you will find in the Attorney-General's reports for 1898, page 156. As I understand the scheme of the Charities Law with regard to the Craig Colony, it was to provide a place for the care of epileptics, and in connection therewith to give them such medical treatment as might be deemed proper. The purpose undoubtedly is to afford them proper relief, if possible, and at least to provide them with a home specially adapted for this class of people. The law under which the Craig Colony was created provides for a Superintendent who shall be a well educated physician and a graduate of a legally chartered medical college with an experience of at least five years in the actual practice of his profession. It seems to me that it must therefore be assumed that the Superintendent is clothed with such incidental authority to perform surgical operations as would be warranted in the ordinary practice of the profession, and if a case arises in which an operation would be considered necessary for the benefit of the inmate, I know of no reason why the Superintendent should not in such case exercise his judgment in the line of his profession and act accordingly; and in my judgment, he is accountable with reference to his action in such a case as he would be in the ordinary practice of his profession outside of the institution. In answer to your last question, I will say that I know of no law which authorizes an autopsy upon an inmate of the Craig Colony; and in my opinion, the same rule would apply to a patient in this institution as does to any other person with regard to an autopsy. I deem it quite unsafe to perform an autopsy upon the body of a patient at the Craig Colony without first having obtained the consent of the friends or relatives of the deceased, or other person rightfully entitled to the body. Yours very truly, JOHN C. DAVIES, Attorney-General. Autopsies upon brains of epileptics. STATE OF NEW YORK, ATTORNEY-GENERAL'S OFFICE. WILLIAM P. SPRATLING, M.D., Medical Superintendent, Craig Colony, Son yea, N. Y.: DEAR SIR. Replying to your letter of September 21st, asking if the provisions of chapter 458 of the Laws of 1905, giving the Craig Colony for Epileptics the right to make autopsies on the brains of epileptics dying at the colony, who are maintained wholly at public expense, would apply to patients admitted to said institution prior to the taking effect of such law, will say, that an examination of the provisions of this law satisfies me that you would have no such right; that its provisions were not intended to be retroactive and that the provision requiring the Craig Colony to print in a conspicuous place upon all application blanks the words "That the said colony shall have the right to make autopsies upon the brains of epileptics," was intended to give notice to the patient and his or her relatives, that that was a condition precedent to his or her right to entrance into the institution and one of the conditions which the State attached before accepting said patient as a public charge. I am therefore of the opinion that you would have no right to perform an autopsy upon the brain of an epileptic who was admitted into the institution prior to the passage and taking effect of the law above referred to and dying after said provisions become operative. Respectfully yours, JULIUS M. MAYER, Autopsies may be held only on deceased patients who were supported wholly at public expense. STATE OF NEW YORK, ATTORNEY-GENERAL'S OFFICE, WILLIAM T. SHANAHAN, M.D., Medical Superintendent, Craig Colony for Epileptics, Spratling Hall, Sonyea, N. Y.: DEAR SIR.- I have your letter of the 19th inst., in which you request my early opinion as to whether or not you have authority to perform an autopsy on patients dying at the Colony who are buried in the Colony's cemetery at the expense of the State at the request of relatives or friends, irrespective of whether or not any money was paid towards the maintenance of such patient. The statute provides that the Superintendent shall have the power "in case of the death of any patient at such institution who shall have been maintained therein wholly at public expense" to perform an autopsy upon the brain of the patient. The power is distinctly limited to the case of a patient maintained wholly at public expense and therefore would not exist where part of the cost of maintenance has been borne by his relatives or friends. I note that you also ask whether, in the case of a patient dying at the Colony and buried there after you have been unable to locate any relatives or friend, you can perform an autopsy irrespective of the time the patient was admitted to the Colony. Under the opinion of Attorney-General Mayer, dated October 3, 1905, it was pointed out that this section is not retroactive and would not give the right to perform an autopsy on the brain of any patient admitted before its enactment. In this opinion I fully concur and it would prevent your performing an autopsy on such patient irrespective of your being able to locate his friends or relatives. Very truly yours, EDWARD R. O'MALLEY, CRAIG COLONY FOR EPILEPTICS - MAJOR SURGICAL OPERATIONS ON INMATES MAY BE PERFORMED IN EMERGENCY CASES.- A patient in the Craig Colony may not be operated upon without his consent either express or implied. A consent, however, to the performance of even a major operation on an inmate may be implied where an emergency arises calling for immediate action for the preservation of the life or health of the patient, and it is impracticable to obtain his express consent or the consent of any one authorized to speak for him. FACTS. At times patients in the Craig Colony for Epileptics become acutely ill and their condition such that, from a medical standpoint, a major operation, such as an opening in the abdominal cavity, is deemed necessary. In some of these cases these conditions develop rapidly so that if any remedial measures of a surgical nature are to be applied, there is no time to consult or obtain permission from the relatives or guardians of such patients. Some of the patients committed, pursuant to the provisions of chapter 588 of the Laws of 1911, are so mentally defective as not to comprehend their condition or pass upon a request for permission to conduct an operation. INQUIRY. Are the colony authorities, in the absence of consent of the parent or guardian, invested with authority to conduct such operations? OPINION. The inquiry relates to several classes of patients. The general scheme of the Craig Colony, as disclosed by article 8 of the State Charities Law, is to provide for the treatment of sane epileptics. These include State patients received there on the written request of friends or relatives or upon the application of the local poor authorities, and private patients received pursuant to agreement entered into with the patient or his friends or relatives. Section 114 of the law, however, as added by chapter 588 of the Laws of 1911, provides for the receipt of "mentally incompetent epileptics." As a general rule no operation may be performed upon a patient without his consent. In certain cases, however, such consent may be implied. And the consent may, I think, be implied in cases such as those herein referred to where an emergency arises calling for an immediate operation for the preservation of the life or health of the patient, and it is impracticable to obtain his consent or the consent of any one authorized to speak for him (30 Cyc., 1576). In the case of insane, adult patients or those who are unable to comprehend or be consulted concerning their condition, if it appears that an immediate operation is necessary for the preservation of life or health, I am of the opinion that the superintendent is authorized to provide for the performance of the same. In the case of insane minors or minors who are unable to comprehend or be consulted with concerning their condition, I am of the opinion that the parents or legal guardians should if possible be consulted with, and their consent obtained, and if they refuse to consent the operation may not be performed, at least in the case of private patients. If, however, the patient has no parent or guardian, or if having one an emergency exists calling for immediate action which makes it impossible or impracticable to consult them, and performance of the operation is necessary to preserve his life or health, consent, I think, may be implied. In the case of a sane adult in such physical health as to be able to consult and advise concerning his condition, no such operation may be performed without his consent. It lies altogether with him to say whether he shall submit to an operation or take his chance of living without it. And I am of the opinion that the same rule applies in the case of those who while minors have reached an age where they are capable of appreciating their condition and intelligently passing upon the situation which confronts them. Their refusal to permit the operation cannot be disregarded. Dated January 18, 1912. THOMAS CARMODY, Attorney-General. To Dr. WILLIAM T. SHANAHAN, Medical Superintendent, Sonyea, N. Y. § 108. Duties of agent in the capacity of treasurer. The agent in the capacity of treasurer, among his other duties, shall: 1. Have the custody of all moneys received from the comptroller for the use of the colony, and all other money, notes, mortgages and other securities and obligations belonging to the colony. 2. Keep a full and accurate account of all receipts and payments as provided by law, and such other accounts as shall be required of him by the managers. 3. Balance all the accounts on his books on the first day of each October, and make a statement thereof, and an abstract of all the receipts and payments of the past year; and within five days thereafter deliver the same to the auditing committee of the managers, who shall compare the same with his books and vouchers, and verify the same by a comparison with the books of the superintendent, and certify the correctness thereof to the managers at their annual meeting. 4. Render a quarterly statement of his receipts and payments. to such auditing committee who shall, in like manner as above, compare, verify, report and certify the result thereof to the managers at their next meeting, who shall cause the same to be recorded in one of the books of the colony. 5. Render a further account of the state of his books and of the funds and other property in his custody, whenever required by the managers. |