Patient safety and informed consent

It’s a legal requirement that patients share decision-making related to their treatment with their physicians. They must be adequately informed of the treatments available and the risks thereto, alternative treatments and their risks, as well as the risk of no treatment, to provide informed consent.

The right to determine what’s done to one’s body

The doctrine of informed consent goes back to the post-World War II Nuremburg Code, created in reaction to the Nazi medical experiments performed upon concentration camp prisoners.

Going forward, there were to be no more unethical experiments performed on people in the name of science. No medical actions of any kind were to be taken without a person of sound mind of the age of majority consenting.

Another aspect of informed consent arises from contract law. The physician is providing a service and, in return, is paid by the patient. All contracts require consent of all parties thereto.

But what exactly constitutes informed consent? What is too little information and what is too much?

Legal guidelines

There are several, acceptable ways to approach this shared decision-making:

• A physician may consider what information does THIS patient need to make an informed decision?
• Alternatively, a physician may simply consider what information the average patient would need to make a decision.
• Lastly, the physician might fall back on what other physicians typically convey to their patients when seeking to obtain their consent.

In an abundance of caution, physicians are well advised to disclose all risks and to go to some length to ensure their discussion has been understood. If a physician doesn’t fulfill this responsibility, the consequences are significant. The physician may face a medical malpractice suit, be removed from preferred-provider lists, and possibly lose hospital privileges.