MED 102Medical Law, Ethics & Bioethics

Chapter 7 - Consent

Objectives

• Explain the consent process from start to finish• Understand the definitions of: consent,

doctrine of informed consent, implementation of consent

• Problems in the consent process (mature minors, emancipated minors, etc.)

Vignette: When is enough enough?

• A client comes in for her annual gynecological examination. Her physician recommends she have a Pap smear, but she refuses. The physician stresses its importance and documents why it is important in the chart. The following year when the client returns for her annual examination, the physician again stresses why she needs the pap smear. The client again refuses. Six months later the client is diagnosed with cervical cancer. Soon she files a lawsuit against the physician.

• Outcome: the jury found the physician liable under the doctrine of informed consent for not stressing more that the client needed a pap smear.

Informed & uninformed consent

• Informed consent

Patient understands an voluntarily affirms to allow touching, examination, or treatment

• Uninformed consent

Patient gives permission but does not understand or comprehend what has been consented to.

Doctrine of Informed Consent

• What the procedure is and how it is to be performed

• The possible risks involved and the expected results

• Any alternative procedures or treatments and their risks

• Results if no treatment is given

Problems with Consent

• MinorsMature minors, emancipated minors

• Language• Competency• Authorization• Implementation of consent• Refusal