Teach residents the importance of informed consent

Residency Program Insider, March 29, 2005

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Dear residency program colleague:

By the time a resident interacts with a patient, he or she is well aware that informed consent is the process of informing the patient about the risks of, and alternatives to, a specific procedure. But like many physicians, residents may view informed consent only as a burdensome legal process. Although this is perhaps true in some respects, informed consent should be regarded as a crucial educational and patient-involvement tool that encourages patients to accept certain responsiblities.

Done properly, informed consent can reduce the patient's expectations to a more manageable and realistic level. It can also reduce the resident's liability by educating the patient and his or her family about the complications that can occur and about the importance of deciding whether the offered procedure is worth the risk.

Nowadays, when disclosure of complications is mandated, informed consent can save the day. Remember, when a patient is told of a risk after it occurs, it is an excuse; when the patient is told of the risk before it occurs, it is part of the informed consent process.

Also keep in mind informed refusal, which evolves when a noncompliant patient simply will not accept a recommendation made by the practitioner. This noncompliance can breed a lawsuit, particularly if the patient dies. For example, the shocked, grieving family may say their family member would never have refused treatment that would have extended his or her life. To avoid such situations, use a simple form that describes the recommended treatment, the reason the treatment is needed, and the consequences of not having the treatment. Upon refusal, the patient signs the form-eliminating any questions about who made the decision and who is responsible.

That's all for this week!

All the best,

James W. Saxton, Esq.
Healthcare Risk Management Institute

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