Informed procedural consent
- Marsha Ryan, MD, JD, FACS
Marsha Ryan, MD, JD, FACS
- Adjunct Professor, School of Law
- Southern Illinois University
- Michael S Sinha, MD, JD, MPH
Michael S Sinha, MD, JD, MPH
- Postdoctoral Fellow
- Program On Regulation, Therapeutics, And Law (PORTAL)
- Division of Pharmacoepidemiology & Pharmacoeconomics
- Department of Medicine
- Brigham and Women's Hospital
Physicians have a legal and ethical responsibility to provide adequate information to the patient so that he or she is able to process the information and make appropriate decisions . An educated patient also benefits the physician, both in terms of cooperation in the planned intervention and in reducing acrimony in case of complications . The physician who teaches and responds carefully brings the patient into the medical decision making process, addresses the patient’s concerns, and creates reasonable expectations regarding outcomes.
This topic focuses on the informed consent session. Additional information regarding the consent process and related ethical issues for adolescent health care, gynecologic care, the intensive care unit, and end of life care is presented elsewhere. (See "Consent in adolescent health care" and "Overview of preoperative evaluation and preparation for gynecologic surgery", section on 'Informed consent and patient expectations' and "Ethics in the intensive care unit: Informed consent" and "Legal aspects in palliative and end of life care in the United States".)
BENEFITS OF INFORMED CONSENT
The benefits of obtaining informed consent extend beyond the simple transmission of information from someone who has knowledge (the physician) to someone who does not (the patient). The benefits of truly informed consent include :
●Protecting the patient’s right of self-determination
●Engaging the patient in his or her health care
Subscribers log in hereLiterature review current through: Jul 2017. | This topic last updated: Sep 19, 2016.References
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- See, eg, Tennessee Code § 63-6-502 (2009).
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- Joint Commission "What Did the Doctor Say?": Improving Health Literacy to Protect Patient Safety, Executive Summary http://www.jointcommission.org/assets/1/18/improving_health_literacy.pdf (Accessed on April 12, 2011).
- Institute of Medicine report. Health Literacy: A Prescription to End Confusion, National Academies Press, 2004.
- Dewes v. Indian Health Service, 504 F.Supp 203 (D. S.D. 1980).
- Appelbaum PS. Clinical practice. Assessment of patients' competence to consent to treatment. N Engl J Med 2007; 357:1834.
- Hanes v. Ambrose, 80 A.D.2d 963 (3d Dep’t 1981).
- Schreiber v. Physicians Insurance Company of Wisconsin. 588 N.W.2d 26 (Wis. 1999).
- Robinson G, Merav A. Informed consent: recall by patients tested postoperatively. Ann Thorac Surg 1976; 22:209.
- Herz DA, Looman JE, Lewis SK. Informed consent: is it a myth? Neurosurgery 1992; 30:453.
- See Jamison v. Kilgore, 905 So. 2d 610 (Miss. Ct. App. 2004)
- Panea v. Isdaner, 773 A.2d 782 (2001).
- Goss v. Oklahoma Blood Institute, 856 P.2d 998 (1990).
- Morvillo v. Shenandoah Memorial Hosp., 547 F.Supp.2d 528 (W.D.Va. 2008).
- Shetter v. Rochelle, 409 P.2d 74, 82 (1965).
- Paden v. Rudd, 669 S.E.2d 548 (Ga.App.,2008).
- Ey RM. "Cause of Action Against Physician for Failure to Obtain Patient's Informed Consent," 5 Causes Of Action § 1 (Updated September 2010).
- Miller-McGee v. Washington Hosp. Center, 920 A.2d 430, 440 (D.C. 2007).
- Aiken v. Clary, 396 S.W.2d 668 (Mo. 1965).
- Spatz ES, Krumholz HM, Moulton BW. The New Era of Informed Consent: Getting to a Reasonable-Patient Standard Through Shared Decision Making. JAMA 2016; 315:2063.
- Canterbury v. Spence, 464 F.2d 772, 791 (1972).
- Bloskas v. Murray, 646 P.2d 907 (Colo. 1982).
- Scott v. Bradford, 606 P.2d 554,559 (Okl. 1980).
- BENEFITS OF INFORMED CONSENT
- INFORMED DECISION MAKING
- Material facts
- Physician disclosure
- Additional procedures
- EFFECTIVE COMMUNICATION
- Focus on the patient
- Comprehensible language
- - Educational material
- - Interpreters
- Emergency situations
- Comatose or incompetent patients
- WITHDRAWAL OF CONSENT
- FAILURE TO OBTAIN CONSENT
- Battery action
- Negligent nondisclosure
- THE DUTY TO INFORM
- Professional standard
- Patient-centered standards
- SUMMARY AND RECOMMENDATIONS