What is informed
consent? Informed consent is the process by which fully informed patients
can participate in choices about Their healthcare. It originates
from the legal and ethical right the patient has to direct what
happens to her body and from the ethical duty of the physician
to involve the patient in her health care.
What are the elements of full informed consent? The most important goal of informed consent is that patients
have an opportunity to be an informed participant in his health
care decisions. It is generally accepted that complete informed
consent includes a discussion of the following elements:
the nature of the decision/procedure
reasonable alternatives to the proposed intervention
the relevant risks, benefits, and uncertainties related to each
alternative
assessment of patient understanding
the acceptance of the intervention by the patient
In order for the patient's consent to be valid, he must be
considered competent to make the decision at hand and his
consent must be voluntary. It is easy for coercive situations to
arise in medicine. Patients often feel powerless and vulnerable.
To encourage voluntariness, the physician can make clear to the
patient that he is participating in a decision, not merely
signing a form. With this understanding, the informed consent
process should be seen as an invitation to him to participate in
his health care decisions. The physician is also generally
obligated to provide a recommendation and share her reasoning
process with the patient. Comprehension on the part of the
patient is equally as important as the information provided.
Consequently, the discussion should be carried on in layperson's
terms and the patient's understanding should be assessed along
the way.
Basic consent entails letting the patient know what you would
like to do and asking them if that will be all right. Basic
consent is appropriate, for example, when drawing blood.
Decisions that merit this sort of basic informed consent process
require a low-level of patient involvement because there is a
high-level of community consensus.
What sorts of interventions require informed
consent? Most health care institutions, have policies that state which
health interventions require a signed consent form. For example,
surgery, anesthesia, and other invasive procedures are usually
in this category. These signed forms are really the culmination
of a dialogue required to foster the patient's informed
participation in the clinical decision.
For a wide range of decisions, written consent is neither
required or needed, but some meaningful discussion is needed.
For instance, a man contemplating having a prostate-specific
antigen screen for prostate cancer should know the relevant
arguments for and against this screening test, discussed in
layman's terms.
Informed consent is the process by which fully informed patients
can participate in choices about their healthcare.
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