We are publically offering a $100,000 reward for any New Zealand doctor, surgeon, District Heath Board (DHB), private hospital, or the Health and Disability Commissioner (HDC) who can provide trusted, scientific evidence that can substantiate that informed medical consent has taken place for laparoscopic cholecystectomy procedures, and that there has not been a false representation of the risks of treatment, and proof that no criminal law has been broken for the treatment of gallstones.

We require information, specifically, that provides trusted scientific evidence substantiating claims made by New Zealand laparoscopic cholecystectomy surgeons, detailed in DHB patient consent information and supported by the HDC are true, honest, transparent and factually verifiable. Furthermore we seek evidence that these claims are fit for purpose and meet the legally enforceable Code of Rights for obtaining informed consent for patients seeking treatment options for gallstones. Subsequently, we seek proof that internationally accepted laws, human rights, professional ethics or the HDC Code have not been violated when obtaining consent for the medical procedure of ‘cholecystectomy’.

Code of Rights, which include but are not limited to:

• The right to be protected from exploitation and medical malpractice, including fraudulent behaviour to obtain informed consent, inflicting cruel, inhumane and degrading treatment on patients; and
• The legal right to make an informed consent, also known as the patient’s right to autonomy,
• The right to have services provided in a legal and ethical manner, free from exploitation and coercion, to minimise the potential harm to patients and optimise their quality of life

The $100,000 reward will be issued to anyone who can produce scientific evidence meeting the following criteria:

• By producing scientific papers, or evidenced-based medical studies supporting each of the listed opinion statements made by New Zealand surgeons to health consumers, in order obtain lawful consent for cholecystectomy. Studies must support that treatment methods are true, honest, transparent and factually verifiable.

• By producing scientific papers, or evidenced-based medical studies supporting ruling statements made by the HDC in support of New Zealand surgeons’ current practices.

• Medical studies must be conducted over a large patient population and over a time period exceeding 7 years and be peer-reviewed by ‘non surgeon’ sources, such as “The American Gastroenterological Association(AGA)” and published in reputable medical journals

• Copyright for all submissions is retained and your submission will be published in full for public feedback and contribution.

• Submissions must include full contact details, any relevant qualifications, institutions and/or associations represented. (I.e. Member of The Health and Disability Ethics Committee (HDEC), administered by the Ministry of Health)

Whistle-blowers welcomed

The NZMA Code of Ethics, Professional Responsibilities states, “Doctors should avoid impugning the reputations of colleagues”. This policy works both ways. Doctors should take every step to exonerate the reputation of their profession and their colleagues, who are bound to the principles of ethical behaviour to respect the rights, autonomy and freedom of choice of the patient, without exploitation.

The Code of Ethics also makes mention of the fact, “Medical ethics cite four moral principles: autonomy, beneficence, non-maleficence and justice. Autonomy recognises the rights of patients to make decisions for themselves. Beneficence requires a doctor to achieve the best possible outcome for an individual patient…. Non-maleficence implies a duty to do no harm”.

Doctors have a responsibility to expose unethical conduct resulting in patient harm. As such, feedback from whistle blowers who can provide information that confirms these informed consent activities are illegal, unethical or cause patient harm is welcomed and will be published accordingly.

https://www.springer.com/cda/content/document/cda_downloaddocument/9781603272452-c1.pdf?SGWID=0-0-45-577128-p173746241

Final word to reward submitters

There must be at least one medical practitioner, doctor or surgeon who would like to earn $100,000 for what should only be a few hours work? It should be very simple, with evidence-based medical studies and scientific proof. In providing this information:

• You will clear New Zealand laparoscopic cholecystectomy surgeons and their employers (relevant DHBs) of any illegal, unethical and criminal conduct for practices carried out on patients. Including blocking post cholecystectomy treatment support and care in order to maintain a false and misleading premise. (I.e. making false claims about the side effect risks and associated problems)
• You will exonerate the reputation of New Zealand laparoscopic cholecystectomy surgeons.
• You will exonerate the reputation of the HDC and its highly skilled, tax-payer funded legal team for their actions, and omissions, in blocking, or failing to properly investigate health consumer’s complaints, in accordance to their statutory duty.
• You will also exonerate the HDC from preventing cholecystectomy patients’ rights being legally enforced under the HDC Act 1994.
• You will clear the HDC of more serious activities:
  • The HDC using its position to conspire, obstruct, prevent, pervert, or defeat the course of justice by covering up informed consent fraud (possibly New Zealand’s largest medical fraud).
  • The HDC’s stated position: ‘Removal of the gallbladder is generally considered to have no lasting consequences”. A surgeon explained the general and specific complications of the procedure. “The types of complications discussed are those arising interpretatively, or well recognised post-operative complications such as bleeding, infection.” You will clear the HDC from endorsing this statement when they noted, “I do not consider that further medical advice is necessary”. Consent is obtained in a complete absence of disclosure of Postcholecystectomy side effects – chronic, life long or otherwise. By clearing the position of the HDC you will prove that it is not in fact a breach of the Crimes Act 1961 No 43 (as of 28 September 2017) section 240 – obtaining by deception or causing loss by deception.  And furthermore, an accessory to medical fraud effecting 10’s of thousand recipients and even patient deaths. (see HDC complaint investigation
  • HDC Supporting rulings of no breach, health complications arising Postcholecystectomy are not a result of treatment provided to New Zealand surgeons, use and presented in patient post care clinical assessment (resulting in blocking support or diagnosis) is not in fact covering up a breach of United Nations Universal Declaration of Human Rights and gross medical negligence.

Article 5: No one shall be subjected to cruel, inhuman or degrading treatment

Article 25: Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, or other lack of livelihood in circumstances beyond his control.

• That the HDC is not in fact an ‘illegal construct’ established to protect medical practitioners, rather than its intended statutory function to protect the rights of health consumers through the HDC Code of Rights, and that:
  • The HDC continue to block patient rights ensuring they are never legally enforced. (I.e. right to make an informed decision on treatment)
  • The HDC continue to provide medical practitioners with the right to practice clinical freedom when the HDC Act is created to prevent this type of outcome (see the Cartwright inquiry)
• And finally, you will clear the HDC and legal team from discrediting and ignoring advice received, which confirms laparoscopic cholecystectomy surgeons are in fact providing services in an illegal and unethical manner through exploitation and coercion. Surgeons are inflicting harm on patients and reducing their quality of life.
• (Attained the by Official Information Act request OIA) In order to position themselves as supporting the opinions of laparoscopic cholecystectomy surgeons:

“…The syndrome (Postcholecystectomy syndrome – see supporting references ) is not a specific diagnosis but refers to a variety of persisting or new symptoms after the surgery that usually required further investigation to establish the cause, and specific treatment. Therefore diarrhoea could be termed a symptom of PCS, as could gastro-oesophageal reflux, but these will require different treatments and may have different causes, although many symptoms can be related to changes in bile flow following removal of the gallbladder.

Most patients with PCS will have a cause identified for their symptoms and appropriate treatment to relieve the symptoms. The syndrome affects probably 10-15% of patients post-operatively but the nature of symptoms will vary – therefore I would regard warning about the possibility of diarrhea, bloating, reflux symptoms………. etc. post-operatively to adequately cover the existence of the “syndrome”

Dr David Maplesden, Medical Advisor, Health and Disability Commissioner                                                                              

100K Reward:  Part A

Provide evidence-based scientific medical research supporting claims made by New Zealand laparoscopic cholecystectomy surgeons (and presented to patients) that are reviewed and signed off by the HDC as true, honest and not a breach of patient rights:

Right 6, Right to be fully informed (1) Every consumer has the right to the information that a reasonable consumer, in that consumer’s circumstances, would expect to receive, including (a) an (honest and truthful) explanation of his or her condition (b) An explanation of the options available, including an assessment of the expected risks, side effects, benefits, and costs of each option. The Code of Health and Disability Services Consumers’ Rights (the Code)

The following opinions, statements, claims made by New Zealand surgeons to health consumers, the HDC and presented in patents medical assessment , to be scientifically proven through evidenced-based research: 

1. Alternative non-surgical treatment options:

1.1 A gallbladder that forms a stone is, by definition, diseased and the only safe treatment to remove a diseased gallbladder is by a ‘cholecystectomy’

1.2 There are no successful alternatives to removing / treating gallstones apart from a ‘cholecystectomy’

1.3 There is no reputable medical evidence-based literature, or evidence, stones can be avoided (treated) by diet change

1.4 ‘Cholecystectomy’ is in general the only option for gallstones

1.5 If a cholecystolithotomy (procedure to remove a stone only, retaining the gallbladder) is performed, the recurrence rate of stones is very high and it is therefore almost never performed.

1.6 Chemicals used for dissolution are toxic and only work for small stones and is old-fashioned treatment. The patient needs to remain on the chemicals for life and it is not a viable option for the vast majority of patients.

1.7 “Gallstones that result from weight loss need removal as they will not disappear without (surgical) intervention” 

2. Postcholecystectomy side effect risks and complications that affect quality of life, chronic, life long or otherwise:

2.1 A patient’s health complications and symptoms developed Postcholecystectomy such as: Gastroesophageal reflux, bloating, fatty liver (non-alcoholic fatty liver), stomach pains (Irritable bowel syndrome -IBS), abdominal bloating, gas, feeling of constant pain, unwell, tiredness, food intolerances, breathing difficulties, rapid weight gain are not possible side effect risks from removing the gallbladder and its function.

2.2 There is nothing in reputable medical literature supporting gastroesophageal reflux to be referred to as a side effect risk or complication.

2.3 Experience of the surgical community over the last hundred years is that digestive tract complication side effects are not an effect of removing the gallbladder function.

2.4 An increased risk of colon cancer in patients who have undergone cholecystectomy is not a proven side effect risk.

2.5 Damage to the stomach or intestinal wall are not side effect risk outcomes.

2.6 There is no adverse effect on the gut’s ability to metabolise fat (no effect on the digestive tract ability to break down ingested fats into essential fatty acids and glycerol).

2.7 No advice on diet changes required, patients can resume a normal diet.

2.8 There is no recognised link between removal of the gallbladder function and weight gain.

3. The following extracts are from DHB’s informed consent documentation used by their employees, New Zealand laparoscopic cholecystectomy surgeons, to legally obtain consent for treatment:

Counties Manukau District Health Board 

3.1″Removal of the gallbladder is not associated with any impaired digestion (in most people)”

3.2 “There is no known means of preventing gall stones”

 Waikato District Health Board 

3.3 People develop gallstones, which form in the gallbladder. They usually end up blocking off the passage (bile ducts) for bile to travel down. Eventually you will need to have an operation to get rid of the stones, hence the cholecystectomy.

3.3 Your gallbladder (and function) is only a place for bile to be stored until needed.

 BOP District Health Board 

3.4 Once the gallbladder has been removed, bile will still flow freely into your small intestine, and you will be able to digest your food normally.

3.5 There is no treatment, or diet, that can prevent or treat gallstones

 Auckland District Health Board 

3.6 You do not need a gallbladder to digest food.

100K Reward:  Part B

Provide evidence-based scientific and medical research that can substantiate claims and opinions made by the HDC that support surgeons’ informed consent practices:

Right 7. Right to make an informed choice and give informed consent (1) Services may be provided to a consumer only if that consumer makes an informed choice and gives informed consent, except where any enactment, or the common law, or any other provision of this Code provides otherwise. (2) Right to make an informed choice and give informed consent. Without this information, patients are denied that opportunity to legally give informed consent. The Code of Health and Disability Services Consumers’ Rights (the Code)

The following claims made by the HDC must be scientifically proven through evidenced-based research in regards to: 

4. An explanation of the options available, including an assessment of the expected risks, side effects, benefits, and costs of each option:

4.1 The HDC: “Removal of the gallbladder is generally considered to have no lasting consequences, although some people experience more frequent and less formed stools or diarrhoea“.

4.2 The HDC responded to a New Zealand surgeon who has explained the general and specific complications of the procedure and stated, “The types of complications discussed are those arising interpretatively, or well recognised post-operative complications such as bleeding, infection.” and, “I do not consider that further medical advice is necessary.”

Right 4(4) Every consumer has the right to have services provided in a manner that minimises the potential harm to, and optimises the quality of life of, that consumer. The Code of Health and Disability Services Consumers’ Rights (the Code)

4.3 The HDC in response to patients’ seeking post care support for the above listed symptoms, dismissed side effects:

4.4 Patients’ physical health deterioration and listed symptom including “reflux, digestion and food intolerance issues, Non Alcoholic Fatty Liver, rapid body mass build-up, fatigue, pain… etc”    is not a result of side effect complications of removal of gallbladder function, or the laparoscopic cholecystectomy procedures carried out by NZ surgeons. And as such, based on HDC rulings, no specific medical advise, post treatment support to be provided to cholecystectomy patients,. 

This  reward has been offered in accordance with the Health and Disability Advocacy Code of Practice. Health consumers, in order to receive informed consent and medical support services, health consumers must take their own direct action to improve health and disability services, including exposing illegal and immoral practices of medical practitioners