What Statement Is Not True about Informed Consent for Surgery

The doctor`s declaration of consent should usually contain a recommendation for treatment. Some clinical ethicists attached to the primacy of respect for patient autonomy argue that physicians should simply provide a menu of options from which a patient can choose independently. We disagree. In our opinion, patients consult doctors for a treatment recommendation and it is appropriate for a doctor to make one. Sick patients feel helpless and dependent. There is evidence that hospitalized patients have evidence of impaired childhood judgment that requires careful medical advice.19 Sick patients need the help and support of doctors to make the right treatment decisions for them. It is important for physicians to provide the reasons for their treatment recommendation in order to give a patient the opportunity to agree with the physician on the facts, but disagree with the opinion. If you have decided to refuse treatment or diagnostic tests, your doctor can inform you of the risks or likely outcomes of this choice so that you can make an informed rejection (that is, you understand what could happen to your health by refusing the recommended treatment, but you still do not want the treatment). In this case, you may be asked to sign a form stating that you have received this information and that you have always chosen not to be processed. Conclusions Surgical consent is not an event or signature on a form, but a process of continuous communication that extends to preoperative, perioperative and postoperative care.

In the context of patient-centered medicine, consent is best conceived as joint decision-making with patients or their surrogate mothers. Consent to anesthesia and surgery should also include a discussion of the patient`s wishes in several planned or expected situations. The first situation is to face an unexpected discovery during surgery. What does the patient want to do if something unexpected is discovered during the operation that requires additional definitive treatment? The patient should be asked if he is willing to authorize the surgeon to perform an additional procedure. The patient`s decision usually depends on the patient`s health goals and the extent to which the additional procedure promotes those goals. Synthesis of data We examined the qualitative aspects of the doctrine of consent. The increase in medico-legal litigation1 and the desire to give patients more weight in their own treatment have highlighted the issue of informed consent and obtaining it. In order for a patient to make a reasonable decision about their treatment, they need appropriate information. This can be done through conversations with medical/nursing staff, through the media/Internet, or through conversations with friends who have undergone a similar procedure. However, it mainly occurs when obtaining informed consent, which explains the risks and benefits of surgery. Informed consent is mandatory for all human clinical trials. The consent process must respect the patient`s decision-making capacity and adhere to each hospital`s rules for clinical trials.

Adherence to ethical standards in the design and implementation of studies is usually monitored by an Institutional Review Committee (IRB). The IRB was created in the United States in 1974 by the National Research Act, which called for regulating human research triggered by dubious research tactics used in the experiments of Tuskegee Syphillis and others. Since then, ethical and safe research standards have been an area of federal and presidential interest, with many organizations and working groups devoted exclusively to this topic since 1974. Valid informed consent for research must include three main elements: (1) disclosure of information, (2) the competence of the patient (or surrogate mother) to make a decision, and (3) the voluntariness of the decision. U.S. federal regulations require a complete and detailed explanation of the study and its potential risks. The consent process ensures that your doctor has given you information about your condition, as well as testing and treatment options, before deciding what to do. Katz AL, Webb SA, Bioethics Committee. Informed consent in decision-making in pediatric practice. AAP News & Magazines; 2016; 138(2):e1-e13.

Children (usually under the age of 17) cannot give informed consent. Therefore, parents must authorize treatments or interventions. In this case, it was not «informed consent» but «informed authorization». An exception to this rule is a legally emancipated child who can give informed consent for himself. Some, but not all, examples of an emancipated minor are minors who are (1) under the age of 18 and married, (2) serve in the military, (3) can demonstrate financial independence, or (4) mothers of children (married or unmarried). Legislation on minors and informed consent is also enshrined in the State. It is important to understand the laws of the state. MedlinePlus. Consent-Adults. 2017.Access to medlineplus.gov/ency/patientinstructions/000445.htm. February 19, 2019. The principle of informed consent is supported by the American College of Surgeons, the world`s largest organization of surgeons with more than 54,000 members.

The college`s policy statements state, among other things, «Patients must understand the indications for surgery, the risk involved, and the outcome they hope to achieve.» The standard required for informed consent is set by the state. The three acceptable legal approaches to adequate informed consent are (1) a subjective norm: what should this patient know and understand to make an informed decision? (2) Adequate Patient Standard: What should the average patient know to be an informed participant in the decision? (3) Reasonable Medical Standard: What would a typical physician say about this procedure? The third element of valid consent is that the patient consents freely. Patients should not be forced to accept treatment by a doctor or agency. Giving a strong treatment recommendation is persuasion, not coercion. Coercion is the use of threats that a reasonable person should not resist.17 It is also a subtle coercion to deceive patients through misinformation or by exaggerating the harm resulting from non-adherence to the recommended treatment, or the benefits of accepting the recommended treatment. Data extraction We extracted data relevant to consent issues in surgical practice. While it may be impossible and harmful to try to discuss all sorts of serious complications before surgery, it is possible to talk about the goals of an individual patient and their importance. It is almost always helpful to involve the patient`s surrogate mother in this conversation.

This communication can be time-consuming, as it necessarily provides opportunities for additional questions, advice and meetings. Diligent surgeons don`t always have time to have detailed discussions. However, the full discussion can be shared as a team with competent assistants (e.g. B, nurses, psychologists or social workers) who can study the patient`s preferences in more detail in different scenarios and involve the surgeon if necessary. Many institutions have developed videotapes or brochures for frequently performed elective procedures that explain in detail relevant facts, including common outcomes for patients.27 The result of this communication process is the development of mutual understanding that can help prevent and satisfactorily resolve conflicts that may arise during postoperative recovery. Consent is an opportunity to guide the patient to the right decision for him and also to dispel the unrealistic expectations of the procedure. Ultimately, it is an opportunity to create a relationship of openness and trust between doctor and patient that can help when surgical complications arise. With high expectations of healthcare, a worse-than-expected outcome can lead to surprise and subsequent anger: good patient education during the consent process is the surgeon`s chance to establish a relationship with the patient and ensure that the patient`s expectations are realistic. .