A premature infant was delivered at Woman's Hospital by the plaintiff. The child died shortly after birth, and the plaintiff was assured by the floor nurse that the hospital would take care of the infant's burial. When the mother went to the obstetrician for an examination six weeks later, she was given her folder to hold while waiting for the physician. She found in it a note from the pathologist about the disposal of the baby's body. When the plaintiff asked the physician about the disposal of the body, he instructed his nurse to take her to the hospital across the street to see someone who would tell her what had been done with the baby. When the woman and the nurse found the person, the plaintiff was handed a large jar with the baby's body inside. As a result, the plaintiff suffered nightmares, could not sleep, was depressed when she was around children, had surgery for a pseudopregnancy, and required psychiatric treatment. Should a patient-physician relationship include the contract to dispose of a dead body?

The doctor - patient contract is normally in the nature of an implied contract, save and except where a written informed consent is obtained.

While there is no majority consensus, in general, the duty is established when a physician affirmatively acts in a patient's care by diagnosing or treating the patient, or agreeing to do so.

A patient-physician relationship exists when a physician serves a patient's medical needs. Generally, the relationship is entered into by mutual consent between physician and patient (or surrogate)

From day one, medical students are taught that their primary obligation is to patients. But defining who their patients are is another matter. Who counts as a patient is a complex legal question that has major implications for determining when a physician has a duty to treat, when a physician can be sued for malpractice, when a physician has "abandoned" a patient, and other serious matters. The legal definition of a patient and the corresponding duties of the physician have been debated in state courts for over a century, and many aspects of the question are still being resolved. This article will explore a number of important legal cases that have helped to define the patient-physician relationship generally, as well as some key exceptions to the general rule.

General Rule
As the cases above demonstrate, states vary in how they define a patient-physician relationship. Physicians should consult with their local medical boards to determine the law for their particular state. As a general rule, physicians are under no obligation to treat a patient unless they choose to. (Exceptions are made when emergency care is needed and when refusal to treat is based on discrimination). However, a patient-physician relationship is generally formed when a physician affirmatively acts in a patient's case by examining, diagnosing, treating, or agreeing to do so. Once the physician consensually enters into a relationship with a patient in any of these ways, a legal contract is formed in which the physician owes a duty to that patient to continue to treat or properly terminate the relationship.
 

Step-by-step explanation

Termination and Abandonment

Where a patient-physician relationship is established, the physician has an ethical and legal duty to continue care and not to abandon the patient. A summary of court cases relating to abandonment posits that, in general, abandonment occurs when the relationship between physician and patient is terminated either at an unreasonable time or without affording the patient time to find a qualified replacement. "Absent good cause where the doctor knows or should know that a condition exists that requires further medical attention to prevent injurious consequences, the doctor must render attention or must see to it that some other competent person does so". A physician must notify the patient and give him or her time to seek care elsewhere. A physician who does not do so can be ethically and legally responsible for abandoning the patient.