The Doctrine Of Informed Consent

Katz states this about informed consent, “to suggest that informed consent with remain a fairy tale as long as the idea of joint decisionmaking, based on commitment to paint autonomy and self-determination, does not become an integral aspect of the ethos of medicine and the law of informed consent” (222).

Although the authors agree with Katz on his view of sense one and sense two, they reason that his model of shared decision making is nothing like informed consent. Shared decision making is when the doctor and the patient reach a conclusion that satisfies them both, but the authors do not agree with this notion because it violates the idea of informed consent by involving the doctor’s opinion. In sense one, the second condition states there should be no manipulation or coercion in true informed consent, and shared decision making does not recognize

Informed consent is the basis for all legal and moral aspects of a patient’s autonomy. Implied consent is when you and your physician interact in which the consent is assumed, such as in a physical exam by your doctor. Written consent is a more extensive form in which it mostly applies when there is testing or experiments involved over a period of time. The long process is making sure the patient properly understands the risk and benefits that could possible happen during and after the treatment. As a physician, he must respect the patient’s autonomy. For a patient to be an autonomous agent, he must have legitimate moral values. The patient has all the rights to his medical health and conditions that arise. When considering informed

The Doctor and Patient relationship aspect of Medicine has changed drastically in the last twenty years. It has evolved from paternalism (the doctor makes the decision for the patient) to shared decision making where the patient is considered an equal partner in his/her own health related decisions. Informed consent is the cornerstone for this view. When a patient or a research subject makes an autonomous decision after understanding, the risks and benefits involved with the decision is Informed consent. Complete Informed consent covers the following components: competency, disclosure, comprehension and voluntary. Competency refers to the requirement for the individual to be of legal age and be mentally competent to understand the process.

Patient informed consent refers to the situation where the patient is fully informed on the consequences of their health care decision after which the patient gives the decision. For there to be informed consent, there are five elements that must be discussed. The first is the nature of the patient's decision then the applicable alternatives to the proposed intervention. Third are the risks, benefits and uncertainties associated with each of the alternatives. Fourth is the assessment of the patient's understanding and last is the acceptance of the intervention or an alternative by the patient. Before the patient's consent is considered to be valid, the patient's competency to make the decision must be addressed. The criteria for evaluating the patient's competency is clearly stated in section 3 of the 2005 Mental Capacity Act which states that provided the person is able to understand, retain and use information provided and to communicate their decision in any way such as talking or sign language, they are competent to make a decision. If a patient is treated against their refusal to consent, it amounts to the tort of battery or can also be considered the crime of assault. In addition to this, laws that touch on human rights reinforce the importance of the protection of the physical integrity of the individual in terms of their right to respect of their private life. Therefore, refusal of medical treatment is a human right.

Every patient has a right to decide on their own course of treatment and freely consent to that treatment. In order to make an educated decision they must be provided with the proper information to make an informed choice (Opinion 8.08 - Informed Consent, 2006). It is the physician’s legal and ethical obligation to provide this information when making their recommendation on treatment. The choices given must be in accordance with good medical practice (Opinion 8.08 - Informed Consent, 2006). The informed consent is the legal policy, either written or verbal, that gives full disclosure of all the information including potential risks that is applicable to the patient’s condition and treatment being offered (Kazmier, 2008).

Obtaining an informed consent is a vital part of current health care. This document lists out several key pieces of information for both the patient, Provider, and the ancillary staff that also access the document during the procedure process. However, obtaining informed consent has not always been the practice norm and in research, informed consent carries different specifications.

In this case, the night of January 11, 1983, Nancy Cruzan was driving a car and lost control of her car as she traveled down Elm Road in Jasper County, Missouri. The car overturned, and Nancy Cruzan was discovered lying face down in a ditch without detectable respiratory and cardiac function. Paramedics were able to restore her breathing and heartbeat at the accident site and she was transported to a hospital in an unconscious state. Then neurosurgeon diagnosed her and found that she is having sustained probable cerebral contusions compounded by significant anoxia (lack of oxygen). The Missouri trial court found that permanent brain damage generally results after 6 minutes in an anoxic state and Nancy was in this stage for 12 to 14 minutes.

Delivery of excellent healthcare involves a multitude of dynamics including an extremely straightforward requirement of a patient’s permission for treatment or procedure. Informed consent, a patient’s authorization, consist of communiqué between healthcare provider or physician and the healthcare consumer, providing sufficient information allowing the patient to make a knowledgeable decision regarding healthcare treatment

The standard of care is the attention you would give to any one of your patients in similar situations. A patient’s best interest is the only one to be considered. An appropriate standard of care would be reached in this case study if you would treat her emergency situation as you would any other, regardless of circumstance and act on that accordingly. There should be no favoritism of judgment in your standard of care. (Caldwell & Connor, 2012, pg. 27).

McCarthy’s recent change in bowel movements, and the failure of conservative treatment measures, and her history of anemia, in supporting the idea that a reasonably prudent patient in Ms. McCarthy’s position would have consented to the colonoscopy. The test of whether the patient would have consented if appropriate information was given is, nevertheless, objective rather than subjective, Marchione v State, 194 AD2d 851, 598 NYS2d 592 (3d Dept 1993). The 4th Department has held that expert testimony regarding what a reasonably prudent patient is required to sustain a claim for a lack of informed consent (this was also a case involving a colonoscopy!). Gray v. Williams, 108 A.D.3d 1085 (4d 2013).

During participant recruitment, participants will be given adequate, relevant and accurate information (Hennink, 2014). This will be reinforced again during the group discussion. This means that they will understand the implications, facts, and outcomes of participating. They will also understand how confidentiality, anonymity and data will be managed how how the results will be disseminated (Wiles, 2013). Participants will be informed that they can chose not to answer any questions if they prefer not to, and have a right to withdraw from participation at any time. Therefore, they will be making informed decision on whether to participate in the focus group. Participants will all be given a written consent form and oral

Shared decision making should involve both health professionals and patients in discussions about their care. “While health professionals hold the expert clinical and technical knowledge, patients are experts about their own lives and treatment objectives, and also what is important to them when making decisions. (Lally, Macphail, Palmer, Blair and Thomsom, 2011).

Shared medical decision making aids in providing evidence based information to patients and their family to assist them to make a decision to meet their health needs. It helps in situations where there is some doubt about the best treatment option and the balance between the harms and benefits are emphasized as much as possible in the information provided.

“Respect for human beings involves giving due scope to peoples capacity to make their own decisions. In the research context, this normally requires that participation be the result of a choice made by the participants” (NHMR, 2007, p.3).  Freegard 2012 (p.60), states that “respecting the rights of others,” includes a responsibility for Health professionals “to let others know about their rights” and that this forms the basis of an informed consent.