Expert Witness Secrets

What factors make patient consent valid?

January 06, 2022 Season 4 Episode 22
Expert Witness Secrets
What factors make patient consent valid?
Show Notes

There are multiple factors to consider when obtaining valid consent from a patient. In my view, the most important aspects to consider are ensuring that you've got all of the alternative treatments documented and shared with the patient prior to the commencement of treatment, that obviously forms the backbone, these multiple treatment choices were potentially possible. But the depth to obtain valid consent is ensuring that the patient understands the risks and benefits of each of the treatment alternatives. This is where consent can become quite complex in nature. If you start to envisage them from the patient's perspective, as long as they are feeling like they are being involved in the decision,  once they've got an understanding of the treatment options available to them and they're then aware of the risks of each treatment option and they're willing to accept the risks associated with the treatment option that they prefer, we're still moving slowly and surely towards the stages, if required to get informed consent. And I think these form the key factors, so that patients feel like they're part of the process. And they are part of the decision making process in particular. The challenge, of course, is most doctors have a very limited time to be able to have this discussion in detail. A lot of the consent process is done with the aid of consent forms. Of course, the challenge with a consent form is that it is usually quite complex and difficult for a patient to understand. Just by simply getting a signature from a patient doesn't necessarily demonstrate, retrospectively, that valid consent was obtained. In my opinion, the key parts to demonstrating that valid consent was taken is the number of stages that were involved. It might start with a high level discussion, information leaflets, recommendations for the patients to either speak to family and friends about the decision, or possibly do their own further reading around it, subject to your advice, so that they can get a better understanding. Of course, nobody can make decisions instantly or even on the same day. We all need time to consider the treatment options. For the purposes of thinking about your process of obtaining valid consent, put yourself in the shoes of a patient and consider a treatment outside of your area of expertise. For example, if you're an IT specialist, think about giving consent for an orthopedic procedure. If you're an orthopedic surgeon, think about having a dental procedure and think about all of the things that you would like to know, within that area that's outside of your area of expertise. Before you were able to make a decision, you'd want to know what the alternatives are. You'd want to know which recommendation that the actual provider of the care is suggesting. In the context of the alternative, they might say we think Option A is the way to go. But this is weighed up against the risks or benefits of option B, C, and D, so that both parties are actually making a decision. The biggest problem I've seen from consent not being valid is that the patient feels like things were being done to them as if they felt like they weren't part of that process. And it goes to an even more philosophical level that the patient doesn't feel like they were heard, they didn't feel like their position, or their feelings, or their interests were put forward. They were rather just told you're going to have to have this procedure done and sign this piece of paper, and we'll get it done. That's not valid consent. Although it might feel like you've got a signature. Think back to the last time you've hired a vehicle from a car rental company. Do you ever feel that you've truly understood all of the risks and benefits and risks associated with hiring a car when you're presented with a 10 or sometimes small print three or four side document that will go through all the disclaimers and all of the the finer details associated with the rental of a car. You may