Consent Defined

12 09 2010

Consent is defined as permission, simply put.  It permits a medical professional to “touch, examine and perform a treatment”, based on that voluntary agreement (Fremgen, 107).  There are various methods of giving consent or permission however, and not all are oral or written in a concise manner that leaves no question.  For instance, implied consent has to be presumed, based on a person’s actions; yet informed consent occurs after an individual has been informed of their options and they make a specific choice.

Informed consent, also referred to as expressed consent, goes beyond having a patient sign on a dotted line to grant said consent.  The patient must have a conversation with their physician which covers the pros and cons of each viable option, detailing not only what might occur if no action is taken, but also the potential results of each action that could be taken (AMA).  If the physician suggests a preferred treatment plan, it is the responsibility of the physician to explain in layman’s terms what counter-effects could result from choosing that plan (Fremgen, 107-9).  It is the right of the patient to make an informed decision and give their informed consent to a treatment plan, based on the factual information they have been provided with (AMA).  Informed consent does not have to be documented with the patient’s signature (unless the laws of that state require it), but proving oral consent could prove difficult in a court of law, making documented signatures of the patient more preferable (Wacker Guido, et al, 173).

Some actions of the patient can be interpreted as giving consent.  When the consent must be presumed based on the actions of the patient, this is called implied consent.  If a patient rolls up their sleeve when a medical professional approaches with a blood pressure cuff, this is viewed as implied consent; because the patient presented their arm for a procedure that was made obvious by the materials present (Wacker Guido, et al, 173).  Likewise, if a patient schedules an appointment for a physical examination, it is presumed that the physician will need to touch the patient to perform the examination, thus the consent is implied (Fremgen, 110).

In emergency situations, where a person is unable to give their refusal or consent, if steps must be taken to preserve their life, consent is presumed and falls under implied consent.  The rule of thumb is that if failure to act could cause a “serious threat to life or limb”, then a medical professional can perform emergency actions when the individual cannot be asked for consent (AAOS, 75-6).  The law presumes that if the patient were able to give their consent to life saving measures, they would give their consent (Fremgen, 110).

Just as a patient has the right to give their consent for treatment, they also have the right to refuse to give their consent.  If a patient is of age and sound mind, it is their right to refuse treatment, no matter the potential outcome of their decision (Fremgen, 111).  The patient may deny consent because of their religious beliefs, their doubts in the medical professional’s capability, their personal beliefs about a procedure or any other reason they feel gives them such cause and it is the legal obligation of the medical professionals to honor that decision (Fremgen, 111).  It is suggested that should a patient refuse to give their consent after being well informed about the possible results, the physician should get the signature of the patient and that of a witness (AAOS, 78).  This step can prove helpful should the issue later be addressed in a court of law.

There is nothing more basic than the right of a human being to make decisions for themselves about themselves and what is done to them.  It is our duty as medical professionals to give the patient all of the necessary information to help them make this decision, and it is our obligation to respect their wishes, no matter how it may counter what we feel is prudent.  With the risk of lawsuits being as great as they are in the medical field, it is imperative that we as professionals document the consent of patients, or their refusal of consent.

 

 


Works Cited

“AMA – Informed Consent.” American Medical Association – Physicians, Medical Students & Patients (AMA). Web. 13 Sept. 2010. <http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/patient-physician-relationship-topics/informed-consent.shtml&gt;.

American Academy of Orthopaedic Surgeons. “Medical, Legal, and Ethical Issues.” Emergency Care And Transportation of the Sick And Injured. Ed. Andrew N. Pollack. Ninth ed. Sudbury: Jones & Bartlett, 2005. 71-89. Google Books. Web. 13 Sept. 2010. <http://books.google.com/books?id=8Q2AliJrOGcC&lpg=PP123&ots=jHMRytPXor&dq&gt;.

Fremgen, Ph.D., Bonnie F. Medical Law and Ethics. 3rd ed. Upper Saddle River, NJ: Pearson Prentice Hall, 2008. Print.

Wacker Guido, Ginny. “Risk Management and Legal Issues.” Ambulatory Surgical Nursing. By Nancy Burden. Ed. Donna M. DeFazio Quinn, Denise O’Brien, and Brenda S. Gregory Dawes. Second ed. Philadelphia: WB Saunders, 2000. 165-89. Google Books. Web. 13 Sept. 2010. <http://books.google.com/books?id=dixpEL1mVugC&lpg&gt;.

 

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