Informed Consent

Student’s Name

Institutional Affiliation

Informed Consent

Informed consent is the process where a treating health care provider discloses to competent patient appropriate information giving the patient a chance to accept or refuse treatment. It originates from the ethical and legal rights a patient has on what happens to their body and from the physician’s ethical duty to involve the patient in health care (Miller & Wertheimer, 2010). Informed consent is voluntary and the concerned patient is given sufficient information on the decision to be made. Informed consent supports consumers as genuine partners in healthcare and facilitates consumer involvement in making decisions. The rights and responsibilities of both the client and physician are important during a counselling session where the client will have their final say before a procedure.

Informed consent is an important issue to the general community which defines health system commitment to consumer engagement that goes beyond diagnostic services (Byrne, 1996). It helps deliver services which are closely aligned with the concerns and priorities of the community. This leads to improved health outcomes and more efficient resource allocation developing a genuine consumer focused health system (Miller & Wertheimer, 2010). Improved communication between consumers and clinicians, contributes to increased adherence to treatment, increased patient satisfaction, reduced emotional distress, increased long-term health system, lower level use of pain relievers, and reduced spending of time in hospitals. When clients are fully informed, they are able to make better use of health services leading to overall low health cost (Clarke & Oakley, 2007).

It also reduces medical errors and is a way of reducing complaints between clinicians and their patients (Byrne, 1996). Obtaining a signature on the consent document is an important requirement but acts as a continuous process of informed consent. A range of problems may occur from poor informed consent process. At an individual level, it can result in the consumer undergoing unnecessary diagnosis and treatment incurring preventable harm. 

In Backlund v. University of Washington, the court had to consider if the injury was caused by lack of informed consent which does not involve negligence. Treatment would be applied through a non-negligent way and still give an adverse effect. If the person was informed about the risks involved, and rejected treatment, the harmful event would not have occurred. In this case, lack of informed consent before the procedure may have caused the injury. The court had to determine if the patient would have rejected treatment if the information was provided. In this case, the court opted for an objective and not subjective causation standard. An objective standard was adopted that sought to determine what a reasonable client would have done in a case as has been done in many other jurisdictions.

Fictional Scenario

Liz is a 39 year old dressmaker married for twelve years. She is deeply depressed and stressed by her inability to conceive. She has gone through expensive and stressful infertility tests which were unsuccessful due to her endometriosis that causes her pelvic pain. It was hard to accept the infertility but she accepts the advice that she would not have children and agrees to have a hysterectomy to relieve the pain and bleeding that are caused by the endometriosis. This would enable her to enjoy life with minimum impairment. Her gynaecologist referred her to my facility for a hysterectomy. Liz requires a preoperative examination, and a consent for the hysterectomy surgery is required.

I welcome Liz to the facility, introduce myself and create rapport to ensure she is comfortable. I give my confidentiality policy that everything we say remains between the two of us, and on the hospital records. I give her the consent form, where she reads the confidentiality policies and signs against it. I explain to her about our financial procedures and how to make the payments. I ensured that Liz is mentally capable in providing consent to her surgery procedure. 

There is a requirement to get informed consent on Liz case. It will provide a legal protection against negligence claims and trespass claims. It will also provide a bottom up demand for information evidence. In order to ensure Liz understands the information, a language that she understand will be used. She is allowed to ask questions and any information would be repeated when necessary. The informed consent should be recorded with the documentation acting as the evidence that the client agrees. There is need for additional evidence that demonstrates the consent is informed acting as a summary of the information given by Liz. This document will act as evidence that informed consent processes are followed to obtain the consent.

On examining Liz, it is clear that she has endometriosis pain but it is found that her uterus is enlarged, information missing from her gynaecologist. While asking the gynaecologist, he replies there was no expectation of pregnancy and that test would not be on Liz’s best interest. I disclose to Liz that her uterus is enlarged and that may be a sign that she is pregnant. There is a recommendation of a pregnancy test before performing hysterectomy without following contrary instruction from her gynaecologist. Obligation of providing material information for the consent overrides the obligation of acting in accordance with the gynaecologist order.

The health care provider is also responsible for explaining the limitation of a procedure and they should discuss confidential information in a private area. The physician or counsellor will be responsible in documentation and ensuring it is accurate, complete, and accessible in future. The client on the other hand is responsible for making the decision of the procedure and giving consent before the procedure is undertaken. She should not hide any information regarding her condition and is required to ask questions when necessary.

Benefits, rights, and the risks of the procedure are explained in detail. She is given a description of the process, nature, expected benefits, purpose, and prospect for the proposed treatment. The hazards that are involved in the process are also explained including pain, discomforts, and side effects. A patient has a right to informed consent and this right should be explained to the patient clearly. She has a right to talk confidentially with a physician and have their health care information protected. She will have a right to easy to understand and accurate information about her health plans, health facility, and physicians. She has a right to respectful, considerate care from their health representatives, doctors, guardians, family, parents, and those selected to assist when she cannot make decisions on her own.

 In case she gets severe pains, sudden illness, or injury that makes them believe that their health is in serious danger, they have a right to be stabilized and screened using emergency services. The client needs to understand the surgery procedure and treatment before deciding on whether to have it or not. She needs to understand the risk of the procedure for example an abortion, and the drawback of the plan will help her in deciding whether the procedure is worth the risk. If she agrees to the procedure, she is required to sign a consent form and all questions should be answered before performing any procedure and before signing.

References

Byrne, J. (1996). Informed consent. New York: McGraw-Hill.

Clarke, S. & Oakley, J. (2007). Informed consent and clinician accountability. Cambridge: Cambridge University Press.

Miller, F. & Wertheimer, A. (2010). The ethics of consent. Oxford: Oxford University Press.