Informed Consent Consent

Consent and Informed consent are two different concepts.
Consent refers to an indication of a patient consenting to a medical treatment (by way of written consent, verbal consent or conduct) that he/she gives consent to the procedure even if the nature, effect and risks of the procedure have not been properly explained to him/her. It constitutes a unidirectional process that the information flows unilateral from the doctor. The patient makes consent with the available information.
Doctors obtain from a patient is not only consent, but also informed consent. It is a process of interactive communication between a patient and clinician that results in the patient’s authorization or agreement to undergo specific medical treatment or intervention.

The patient must have the capacity (or ability) to make the decision.
2. The medical provider must disclose information on the treatment, test, or procedure in question, including the expected benefits and risks, and the likelihood (or probability) that the benefits and risks will occur.
3. The patient must comprehend the relevant information.
4. The patient must voluntarily grant consent, without coercion or duress.

Nature and importance of consent in medical practice has been discussed in previous chapter (Chapter 8: duty of disclosure and consent). This chapter focuses on the concept of informed consent. The key question is: how much is enough?

A patient suffered from post-operative uveitis after intra-ocular lens surgery made a claim against her ophthalmologist for medical negligence. She claimed that she was not give informed consent prior to the surgery. Even though the final visual outcome was excellent but she suffered a period of reduced visual acuity. Expert opinion found that the post-operative care was suboptimal and detailed informed consent was absence in patient’s note. MPS identified the case indefensible and a settlement was made. It is because there was no record of any information of complication of the surgery in the patient’s

The claimant should be responsible to prove if there is a factual issue as to whether a warning was given or not, particularly when medical notes indicate that a warning was given. In this case, it was for the claimant to establish that she had not been warned in respect of the proposed surgery to the tooth on the right side, he would inevitably have concluded, in light of the findings that he had made, that no such warning had been given.

The case tells us that it is better to have a standardized written consent form. More marking (different colours) on the note and the consent is a good practice. Severe risk should be well informed. The warning should be high-lighted and the patient should have some reactions like a thought of refusing surgery.

New law in informed consent – case of