Legal and Ethical Aspects of Medicine – Consent: By Nelson Chan M.D.
As a physician, it is your duty to provide
your patients with the relevant medical information in order to help them choose a treatment plan.
Even if a treatment is medically indicated and you think it is in their best interest,
it is ultimately up to the patient to decide whether to proceed. Here are 3 things that you should not miss
when obtaining a valid consent: Assess the patient’s capacityBefore you
even obtain consent, you need to be satisfied that the person can understand the nature
of the proposed treatment, its anticipated effects, and the consequences of refusal.
In most provinces, capacity does not depend on age but varies according to the person
and the complexity of the decision. A 10-year-old may appreciate that his broken foot needs
a cast but that same person may not understand the operation proposed to fix it.
Inform the patient of any special risksDuring the consent process, you will need to provide
your patients with information about the expected benefits, possible material risks, any alternative
course of actions, and the likely consequences of not having the treatment.You should also
discuss any special risks that might apply to the particular patient. Developing an abnormal
sense of touch after carpel tunnel surgery may affect a dentist differently than a retired
librarian. Be sure that the person is giving consent
voluntarilyWhen getting consent, take care to ensure that this person is choosing freely
and is not being coerced by anyone, including you.Patients should be given an appropriate
time to deliberate and the information should be presented factually. While in some cases
it may be important for the patient’s friends or family to provide input, remember that
you are only treating the patient. Patients have the right to choose, doctors
have the duty to inform.