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. Disclosure relates to knowledge of the relevant risks and comprehension means fully understanding the pertinent and factual risks before consent. Voluntary is when the decision is without coercion or duress. (Colston, 2004)
Today Informed consent is a routine process required by law not only in the clinical setting but also in research. In United States, in clinical settings the physician performing the procedure obtains informed consent. The Joint Commission on Accreditation of Healthcare Organizations is responsible for overseeing the implementation of informed consent.
Since the implementation of Informed consent is dependent on the healthcare provider, it varies significantly and hence susceptible to lawsuits. There are no federal law listing the procedures, decisions and tests, which require Informed consent. Hence, it is upon the hospitals and medical professions to decide on the local guidelines for informed consent (Terry, 2010). The legal criteria for determining informed consent div...
... middle of paper ...
...ts of informed consent competency, disclosure, comprehension and voluntary. In using telehealth for the provider, it is sometimes difficult to judge if the patient fully understands his/her medical condition and the reason for the visit.
Etherapy has its own set of implementation issues concerning informed consent. In counseling one of the most important tools in gauging the patients comprehension or competency is judging their reactions and emotions. In e therapy or phone therapy unless the counselor sees the patient through video it is very difficult to measure comprehension or competency. Moreover, in e therapy the patient sometimes use emoticons to depict their emotions. Nevertheless, the emoticon they choose might not show their true emotion and thus make it difficult for the counselor to gauge their real feelings leading to misdiagnosis or wrong treatment.
Autonomy is a concept found in moral, political, and bioethical reasoning. Inside these connections, it is the limit of a sound individual to make an educated, unpressured decision. Patient autonomy can conflict with clinician autonomy and, in such a clash of values, it is not obvious which should prevail. (Lantos, Matlock & Wendler, 2011). In order to gain informed consent, a patient
According to Terrence F. Ackerman, as of the 1980s the American Medical Association had to include the respect for a person’s autonomy as a principle of medical ethics (Ackerman 14, 1982). This includes having the physician provide all the medical information to the patient even if the information could cause negative implication onto the patient. The physician is also expected to withhold all information of the patient from 3rd parties (Ackerman 14, 1982). Although it is seen as standard in today’s world, in
In the case study, Betty was adamant in refusing treatment, despite the risks of the illness progressing and potentially leading to death; under the laws of the medical treatment act (1988) any adult who exhibits competency has the right to refuse treatment, even if refusal of care increases the risk to their health, this right is based on autonomy (3). The information outlined suggests that Betty was capable of making a decision as she fulfils all the elements of consent; therefore she is competent and has the right to deny treatment. Betty acknowledges the risks of not receiving treatment and admits that not receiving treatment will make it difficult, demonstrating her sound understanding of the risk and benefits of the outcomes. For a patient to fulfil the element of understanding they must receive, process and incorporate the information they are provided with into their own personal values and Betty demonstrates this level of understanding by sticking to her values, her decision to stay home and by acknowledging the difficulties and risks of not receiving treatment (3). Once Betty received a diagnosis she was informed by the paramedic of the outcomes and potential risks of not receiving treatment for her condition, Betty was sufficiently informed with information and risks relevant to her situation, enabling her to make an informed decision (3). In order for consent to be considered voluntary, a patient must consent to treatment in an environment free of threat and pressure; if a patients decision is genuine they will also accept responsibility for the outcomes and understand the risks (3). Voluntary consent is a slightly grey area in Betty’s scenario, her son is potentially placing pressure on Betty with his demands, however, Betty expresses responsibility by admitting it will be difficult to and
Providers must act in the best interest of the patient and their basic obligation is to do no harm and work for the public’s wellbeing. A physician shall always keep in mind the obligation of preserving human life. Providers must communicate full, accurate and unbiased information so patients can make informed decisions about their health care. As a result of their recommendations, providers are responsible for generating costs in health care but do not generate the need for those expenses. Every hospital has both an ethical as well as a legal responsibility to provide care, even if the care may be uncompensated.
Informed consent does not simply mean to have a patient sign a white piece of paper with a list of information prior to any type of medical treatment or procedures. Informed consent requires a lot of education and advocacy for the patient. Although informed consent is provided by a health care provider, it the nurse’s duty to act on the patient’s behalf by protecting patient’s right to autonomy (Cook, 2014). There are four key elements of informed consent for nurses (Judkins-Cohn, 2014). First, nurses must make sure the patient is in the right state of mind to comprehend the activities that will happen. Second, the patient should be educated about all the possible risks and benefits before agreeing
Truog, Robert D., Walter Robinson, Adrienne Randolph, and Alan Morris. "Is Informed Consent Always Necessary For Randomized, Controlled Trials?" The New England Journal of Medicine 340, (March 1999): 804-807.
This paper will address the ethical dilemma of informed consent vs the right to refusal of treatment by the patient. I will show the
A consent can be either written or verbal and must be given by the patient authorizing that a procedure be done on them. Every patient has the right to agree or refuse any healthcare treatment that they may be offered. The consent can not be forced and must
Consent is an issue of concern for all healthcare professional when coming in contact with patients either in a care environment or at their home. Consent must be given voluntary or freely, informed and the individual has the capacity to give or make decisions without fear or fraud (Mental Capacity Act, 2005 cited in NHS choice, 2010). The Mental Capacity Act perceives every adult competent unless proven otherwise as in the case of Freeman V Home Office, a prisoner who was injected by a doctor without consent because of behavioural disorder (Dimond, 2011). Consent serves as an agreement between the nurse and the patient, and allows any examination or treatment to be administered. Nevertheless, consent must be obtained in every occurrence of care as in the case of Mohr V William 1905 (Griffith and Tengrah, 2011), where a surgeon obtain consent to perform a procedure on a patient right ear. The surgeon found defect in the left ear of the patient and repaired it assuming he had obtained consent for both ear. The patient sued him and the court found the surgeon guilty of trespassing. Although there is no legal requirement that states how consent should be given, however, there are various ways a person in care of a nurse may give consent. This could be formal (written) form of consent or implied (oral or gesture) consent. An implied consent may be sufficient for taking observation or examination of patient, while written is more suitable for invasive procedure such as surgical operation (Dimond, 2011).
The law does not give permission to the health care professionals to disclose the medical information of the patients. It is the right of a patient to have his or her personal identifiable information to be confidential. This medical information is suppose to only be available to the physician of record as well as other necessary health care and insurance personal. Confidentiality of patient was protected by federal statute, as of 2003. Passing of federal regulations which was the Health Insurance Portability and Accountability Act of 1996 was facilitated by the requirement of having privacy as well as protection of personal records and data in an electronic medical records environment and third party insurance payers.
According to Medical Dictionary (2003) ‘consent’ is an ‘act of reason’, voluntary agreement to proposed treatment made by a mentally capable person upon receiving relevant information. Patients’ consent is closely associated with individuals’ liberty, person’s autonomy and the right to decide about themselves and their body with assumption of taking full responsibility for decision and its consequences (Frith and Draper, 2004).
To begin, to those who may wonder what informed consent is, it is a legal and ethical prerequisite for clinical research on humans (Bristol, par 2). The purpose of informed consent is to ensure that patient autonomy is respected in decisions about their healthcare (Susilo, 1). Many people say that the term was first used in 1957. There was a malpractice case with Salgo v Leland Stanford Jr. The California Supreme court stated that no patient can submit to a medical intervention without having given “informed consent”. Even though the courts had said this, inf...
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 consent, the patient must be aware and should be able to give a voluntary consent for the treatment and testing without being coerced, even if coercion is very little. Being coerced into giving consent is not voluntary because others people’s opinions account for part of his decision. Prisoners and the poor population are two areas where coercion is found the most when giving consent. Terminally ill patients also give consent in hope of recovering from their illness. Although the possibilities are slim of having a successful recovery, they proceed with the research with the expectation of having a positive outcome. As stated by Raab, “informed consent process flows naturally from the ‘partnership’ between physician and patient” (Raab). Despite the fact that informed consent is supposed to educate the patients, it is now more of an avoidance of liability for physicians (Raab). Although the physician provides adequate information to his patient, how can he ensure that his patient properly ...
Patients’ have the right to know all details related to the service or treatment that will be provided and the right to refuse any such service or treatment before it happens. This informed consent will communicate exact procedure details, pain intensity and or disability period encountered, risk involvement, and any alternative methods of treatment and its risks. A patient will receive a concurrence...
Informed consent is a very serious decision a patient has to make when it comes to their health and consenting to procedures that are believed to cure or treat their current health status. It is important to address the effectiveness of the role a physician play in the informed consent process assuring that the patient has given truly informed consent and what safeguards can be put in place to assure the patient is exercising informed consent. Informed consent is based on the fact that the person consenting is a rational individual that is aware of the action to which he/she is consenting. Allen and McNamara (2011) notes that "On the standard understanding, the important elements of informed consent are the provision of information, the voluntariness of the choice and the competence of the chooser to make the choice— so the potential research participant should be provided with information relevant to the decision to participate, they should be able to choose freely about their participation and they should be competent to decide.