Limitations, Loopholes and Benefits

INFORMED CONSENT What it is:

Based on the legal premise of Patient Autonomy, patients have the right to make decisions about their own health and medical treatment.

The physician must disclose: The patient’s diagnosis, if known Nature and purpose of the proposed treatment Risks and benefits of a treatment or procedure Alternatives to certain treatments regardless of

cost Risks and benefits of alternate treatments Risks and benefits of not receiving a treatment or

undergoing a procedure.

First introduction of the idea of informed consent was in the court case Mohr vs. Williams (1905).A physician obtained Anna Mohr’s consent

to an operation on her right ear, but during surgery, the surgeon decided that her left ear needed surgery instead and operated on it.

The judge determined that the physician should have obtained the patient’s consent to surgery on the left ear and therefore: a physician needed to advise a patient of all the information related to a particular procedure, including all risks and benefits.

Canterbury vs. Spence: Informed consent emerged as a legal right

with full redress equivalent to battery if the informed consent was not given.

Patient Self-Determination Act (PSDA)Passed in 1990, gave the public the right to

be fully informed and fully self-determining in end-of-life decisions.

We should be completely protected and informed in our decisions…

Patients have legal protection for medical decisions as well as the right to information about all available procedures. Patient’s religious and social views can be preserved

and all sorts of treatments can be explored.

The patient can form a relationship with the physician through the process of informed consent. “But the documents are at best props in the

theater of informed consent. It’s the process itself that is really important.”

~Dr. Eric D. Kodish, senior author of the study and a professor of pediatrics and chairman of bioethics at the Cleveland Clinic.

http://www.nytimes.com/2009/07/30/health/30chen.html

The PSDA protects patient’s rights to decisions about treatments and procedures, but how do we know what we are being told is true? Or even the whole truth?When does manipulation and coercion come

into play?

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Doctors are not supposed to coerce patients into suggested treatment, according to informed consent. But how do we detect a little blurring of the

facts, some half-truths, and missing information?

Are we really qualified to make decisions about medical treatment? We aren’t doctors.

When does informed consent get in the way of treatment?

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If told that possible risks included death or permanent incapacitation, what risks are worth it?

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Doctors allowed to forcibly operate on woman with phobia of hospitals Court rules 55-year-old woman with learning

difficulties can be coercively sedated in order to have life-saving cancer surgery

Dr. Sarada Mylavarapu, an anesthesiologist at Fountain Valley, recalls watching helplessly as a 48-year-old mother of two died during open-heart surgery several years ago. "It was gut-wrenching to watch - she was bleeding to death,"

Mylavarapu said of the woman, a Witness."Just blood - that was all she needed." But it is a crime for doctorsto give blood to an adult patient who refuses it.

http://www.guardian.co.uk/law/2010/may/26/doctors-operate-woman-phobia-hospitalshttp://www.mombu.com/gardening/gardening/t-transfusion-free-surgery-a-religious-belief-of-jehovahs-witnesses-may-also-be-good-medicine-for-everyone-medicine-have-silver-walking-large-2941901.html

OPPOSITE ENDS OF THE SPECTRUM Forcing treatment on a patient despite

their personal wishes and views.Reasoning: the patient’s life is a higher

priority than their stated wishes Hidden reasoning: the patient cannot, does not

understand the situation

Refusing to administer treatment and risking death by respecting a patient’s desires. Reasoning: the patient’s pre-stated

conditions are of higher priority. Hidden reasoning: Legal repercussions

WHAT IT ALL COMES DOWN TO What do people value more, their pride

or their life? Morals and ethics or life?

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PERSONAL VIEW If treatment determines life or death,

life is more valuable than pride; under certain circumstances.For example: life support. The choice

cannot be made by the patient on life support, so the patient’s consent does not apply because the patient will have a designated decision-maker.

WORKS CITED http://www.deathreference.com/Ho-Ka/Informed-Consent.html

http://www.emedicinehealth.com/informed_consent/article_em.htm

http://www.guardian.co.uk/law/2010/may/26/doctors-operate-woman-phobia-hospitals

http://www.mombu.com/gardening/gardening/t-transfusion-free-surgery-a-religious-belief-of-jehovahs-witnesses-may-also-be-good-medicine-for-everyone-medicine-have-silver-walking-large-2941901.html

http://www.nytimes.com/2009/07/30/health/30chen.html