Informed consent is a major part of medical care and treatment, and many do not even know which part of their care this refers to. Most patients follow all their doctor’s advice and recommendations for treatment and care, but no one is ever required to follow their suggestions. If you are an adult seeking medical care, and are of sound mind and body, you can make your own informed consent, most often by signing a medical form that outlines the plan of care or treatment discussed by your doctors.
All medical care received requires the consent of the patient to proceed and treat before any care is given. In some cases, agreeing to what your doctor instructs you to do is considered informed consent. When you seek out the care of a specialist after receiving a referral from your primary care doctor, you have given informed consent. When you fill a prescribed medication at the pharmacy that your primary care physician or specialist has prescribed, you fill out a form of informed consent. The same could be said when you carry out blood tests and have blood drawn. Some of these things are called simple consent and usually refer to medical care that poses little risk to the patient (CDC/NIH).
In certain cases where the adult cannot sign for themselves, they will have a proxy person involved who will be able to sign all consent forms, helping and assisting with their medical care and plan. For children, this is most often a parent or legal custodian. As children age to the teenage years, parents are still required to sign all consent documents, however, some states now also require the teens to sign as well. This type of ‘assent’ happens to allow the child to be able to speak for themselves, too (NIH).
If the patient is not mentally or emotionally sound, they may still understand the medical treatments that they need. In these cases, all information is still presented to all parties and questions are asked for answers. The mentally or physically handicapped person may not sign their own informed consent forms, but many doctors and specialists feel including all involved in the process is best for the calmest and most positive outcome (NIH/CDC).
If you or a family member have been incapacitated for any reason, you may need a more direct form of advance directive such as a health care power of attorney or durable power of attorney. With this type of legal document, another person is made legally responsible for your medical care and decision making. This option requires visiting a lawyer and creating official and notarized documents. Another option that happens when sudden medical necessity arises is the court appointed proxy. A court appointed proxy can be a family member, doctor, or anyone who petitions the court with valid reason to step in and help with your medical care and decisions on your behalf. A judge makes this determination in court on a temporary or permanent basis, depending on the situation (ACS).
The Process of Informed Consent
From the moment your doctor or nurses begin explaining the medical procedure, treatment, or process to you, they are preparing you to know everything that is going to happen to you so that you can give them your consent to be treated. This is a vital part of medical care as knowing what you are doing and going through is very important to help avoid misconstrued advice, care, or treatment plans. Informed consent will likely involve these things:
- You can use the information to decide what you think is in your own best interest.
- You share your decision with your doctor or treatment team.
- You can plan to seek a second opinion.
- You are told or get information about the possible risks and benefits of the treatment.
- You are told about the risks and benefits of other options, including not getting treatment.
- You have the chance to ask questions and get them answered to your satisfaction.
- You have had time, if needed, to discuss the plan with family or advisors (CDC/NIH).
If after getting all the information needed you elect to proceed with the treatment or procedure, you are then given a paper called a consent form. Once signed, this document is legal and allows the doctor to go ahead with the plan you have agreed upon. This form will list the procedure to be done, treatment plan, or any extras that will be done with the treatment. Otherwise, the form is very general having your basic patient information on it, and other possible details about your upcoming procedure. Depending on the doctor’s system, you may only sign one consent form for all procedures, or one per procedure (CDC/NIH).
Cancelling Informed Consent
Yes, informed consent can be “canceled” and you can change the course of your treatment or stop it all together at any time. Generally, consent forms have a section that explains that you can stop treatment and care at any time, even if you have already signed the consent form. When you know that you need to rescind your consent, begin by contacting your doctor’s office immediately and informing them of your plans. You may need to sign a new form stating that you have denied consent and wish to stop or change your treatment plan (CDC).
If you have decided that the treatment plan you have agreed to or already begun no longer suits your needs, you may stop treatment at any time. If another treatment plan is available, you can switch at this time. You may also choose to accept parts of the treatment plan proposed, and not accept the entire thing. In this instance, if you choose to not follow your doctor’s plan, your doctor may refuse to treat you. This is common in these situations, as the doctor us ultimately responsible for your care. If this happens, you will be required to find a new doctor and begin the process with them over again at their office.
Once you have decided to forego treatment, even with the chance of death, your health care provider will again cover the risks you open yourself up to with the ceasing of treatment and care. You might be asked to sign a form that states you have been given all aspects and points of information about your care, even when you are choosing to stop being treated. If you do not sign this form, your doctor may require a nurse or other patient advocate to witness you being told the information. This helps to protect the doctor and facility to medical liability lawsuits (NIH).
Questions to Ask Medical Professionals about Informed Consent
If your doctors or nurses do not give you all the information you need, or you still have questions about the treatment or procedure, do not hesitate to ask. Here are the most common general questions asked about informed consent.
- How would not having treatment affect my normal functions and everyday activities?
- How long will the treatment last?
- How long will it be before I can go back to my normal activities?
- How much does the treatment cost?
- Will my insurance cover it? How much will I have to pay out of pocket?
- What is the medical name of my diagnosis and what does it mean?
- How serious is my diagnosis?
- What treatments are recommended?
- Are there other treatment options? What are they?
- What benefits can I expect from the recommended treatments and the other options?
- What are the risks or complications of the recommended treatment and the other treatment options?
- Are there problems or side effects that may be caused by the treatments?
- What will be done to help prevent or relieve these problems or side effects?
What are the side effects of the treatment – immediate, temporary, and long-lasting?
- How will having treatment affect my normal functions and everyday activities?
Most doctors appreciate a patient that asks questions and takes responsibility for their medical care. It is always advised to write down any questions in a notebook so that you can jot down answers given in a safe place. Some doctors allow people to bring in personal recorders and record the conversation to have on tape to go back and listen to when you are calmer and less stressed. Not all doctors or specialists allow this so please be sure to ask before recording anything in a medical setting (CDC/NIH).
If you have questions about informed consent and how it affects patient care, simply contact your medical care team, or ask to see these forms when you are in for a visit. The important thing to remember is that without this type of informed consent, doctors and specialists are unable to move forward with your medical care and plan (CDC/NIH).
Citations:
American Cancer Society
Cancer.org
National Institutes of Health and Human Services
Empowering Intimacy
Centers for Disease Control and Prevention