PLANNING AND LEADERSHIP FOR A BETTER WORLD
PLANNING AND LEADERSHIP FOR A BETTER WORLD | Table of Contents: |
If you've ever had any kind of medical or dental procedure—major or minor—you've had to sign a consent form. The doctor or hospital is legally and ethically required to inform you about the procedure and secure your consent to it.
Doctors rarely present a full and clear picture
of procedures and risks before expecting patients to sign consent forms.
The American Medical Association defines these informed consent criteria:
● The patient's diagnosis, if known
● The nature and purpose of a proposed treatment or procedure
● The risks and benefits of a proposed treatment or procedure
● Alternatives (regardless of their cost or the extent to which the treatment options are covered by health insurance)
● The risks and benefits of the alternative treatment or procedure, and
● The risks and benefits of not receiving or undergoing a treatment or procedure.
Informed consent has a dual purpose: to make sure you understand the risks and benefits, and to protect the hospital or doctor from lawsuits in case something goes wrong. It is legally required in all 50 states.
In many cases, hospitals and doctors go about securing consent with an oft-photocopied stack of papers detailing the risks of the procedure. You may have a few minutes to review it and sign before someone—a nurse or an administrator, but almost never a doctor—comes back to collect it. They'll ask, perfunctorily, if you have any questions, but most people don't. The unspoken implication is, "This is a routine procedure, just sign on the dotted line and let us do our jobs."
Obviously, there are numerous problems with this approach. Unless it's an emergency situation, you have several treatment options, and you can't make an informed decision without all the facts. Also, if you don't have a clear understanding of what's going to happen, you may suffer from unnecessary anxiety or apprehension. There's less ownership of the decision and of the treatment regimen on the patient's part, and greater likelihood of misunderstanding—and perhaps litigation—after the fact.
Another problem with a less-than-full understanding of the procedure is that you may find that the procedure isn't necessary. According to the Foundation for Informed Medical Decision Making, many doctors and hospitals order unnecessary, or unnecessarily invasive, tests, and patients go along for the ride without question.
From the Foundation Website:
"A recent survey of patients conducted by the University of Michigan found that fewer than one in five was asked by their health care provider about their preferences for care. Less than 50% were able to answer basic questions about their condition and its treatment—information that a truly informed patient would understand prior to making a treatment decision. The survey also found that providers often neglected to tell patients about the potential disadvantages of treatments or tests that they recommended."
Fortunately, a new, technological approach to informed consent is gaining popularity. Several companies are fielding software or Web-based tutorials that explain procedures and risks in a multimedia format, with pause, rewind and Q&A features to ensure that patients really do understand what they're getting into and consent fully.
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