Informed consent is required for every invasive medical procedure, from getting your ears pierced to having an abortion – Bob McDonnell
By Anu Dev
Every day, at some point, we usually have to make decisions: whether it’s a decision about what we’ll wear, or what we’ll eat, or what TV show we should start binge-watching. And despite those being seemingly not very ‘serious’ decisions, most of us still take time to weigh our options and make a decision based on all of the facts we have at our disposal.
Basically, what I’m getting at is that we all like to have all of the facts before we make a decision or commit to something; that’s just being rational. But there’s one area in our lives that, many times, we’re kind of shoe-horned into making decisions without having all the facts, or understanding all of the facts. And those are decisions that we make when we come into contact with the medical profession — when the question might literally be one of life and death.
One of the things that I’ve noticed when I’ve gone to hospitals (as a patient) is that there are some doctors who often don’t take the time to explain fully to their patients exactly what’s wrong with them, and precisely why they’re suggesting a particular method of treatment.
And it’s extremely ironic that it’s the area of our life that’s the most “life-or-death” that we’re the least informed about when making decisions. Can we still call them “consent”? I wonder: are we just going along with what the doctor decides? For consent to be valid, it must be “informed consent”, and we have a big role to play in “informed consent” also.
Think about it: “informed consent” must be given voluntarily (with no coercion or deceit) by an individual who has capacity, and by an individual who has been fully informed about the issue.
Interestingly, what we’re being taught at school is that obtaining informed consent is a legal and ethical necessity before treating a patient. It derives from the principle of autonomy — one of the 4 pillars of medical ethics: Autonomy, Beneficence, Non-maleficence and Equality. The ethical principle of autonomy requires that patients should accept or reject treatment based on a true understanding of their situation and on their personal philosophy.
But numerous studies have suggested that patients are giving consent based on misconceptions. There is a failure of communication: doctors are not doing a good job of providing accurate information, and/or patients are failing to process that information. I suspect it is a combination of both. While “informed consent” is great…how many of us can digest what the doctor might be talking about?
So it’s important to trust your doctors. They’ve take an oath to ‘do no harm’ (Principle of Non-maleficence) to their patient; so their decisions aren’t made to hurt patients, but rather to help them. But at the same time, many times there’s more than one way to go about helping the patient. A surgeon might be more likely to recommend a surgical intervention not because he/she wants to cut you open and make money off of you, but because that’s his/her specialty and those interventions are what he/she knows work. A medical doctor would probably suggest going a more medical route, treating the patient with drugs. Second opinions can help in this area.
As a patient, you have the right to ‘informed consent’, which means that if you need treatment, your healthcare provider must give you the information you need to make a decision. You shouldn’t have to blindly go along with treatment; you have a right to know exactly what it is you are agreeing to.
Consent means nothing if the patient doesn’t know what they’re giving permission for. It’s like those times kids try to get their parents to sign a blank piece of paper so that they can write an excuse to their teacher for missing school.