Ethical Issues Involved in Obtaining Consent for Treatment

Ethical Issues Involved in Obtaining Consent for Treatment

Medical consent is the act, in healthcare, of informing patients of disease processes, its natural history and treatments or observation of such. Consent involves competing values of patient autonomy versus provider paternalism and much of the ethical controversy resides here. Consent is commonly written, but may be oral or implied, and is often supported with decision aids such as written materials, videos, etc.

The ethics of medical consent requires a greater standard than the legal requirement. Consent, as defined by law, must be voluntary, competent, and informed. The ethics of each component may violate the provider's fiduciary duty. Voluntary consent may be fraught with inconsistencies, duress, or perceived duress of the patient. The patient values autonomy but may have concerns for: (a.) continued physician relationships, (b.) family pressures, or (c.) clouded judgments from their diagnoses. Competence may be straight forward, and requires conscious adults without obvious mental deficits. Competence excludes minors, mental illnesses, and undue duress. Informed consent requires both information and adequate delivery.

Expectations by Clinicians for Voluntary, Competent and Informed Consent

Clinicians have a fiduciary duty to provide consent and must be assured that it meets expectations. Voluntary consent must be achieved without any real or perceived duress. It is voluntary when all of the patient’s questions have been answered satisfactorily and they are agreeable. Enhancement of the voluntary element occurs when consent is obtained on any day prior to treatment. The dissociation of obtaining consent from the day of treatment gives reasonable pe...

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...tent (i.e. conscious and conversant), and informed (quantitative versus qualitative). As a patient, my inclusions for consent are the same: informed knowledge with permission. The natural history of the disease and the Standard of Care for treatment are required. Information about choices which deviate from the Standard of Care should be included. Quantitative imperative is unnecessary depending on the educational level of the patient. Its disclosure may potentially harm or cause duress for the patient. For me, as a patient, quantitative imperative would not require inclusion.

Works Cited

[1] Darr, Kurt. Ethics in Health Services Management, 5th ed. Baltimore: Health Professions Press, 2011.

[2] Schwartz, Peter H. Questioning the Quantitative Imperative. Decision Aids, Prevention, and the Ethics of Disclosure. Hastings Center Report. 2011. 41(2): 30-39.