Informed consent is a process

Informed consent is a process by which the physician obtains authorization from the patient to undergo a particular medical intervention, after explaining the details, its benefits and the risks, and existence of any available alternative, in a manner which the patient comprehends the best.  It can be oral or written, and can be implied (situation arises in which a consent has to be given) or expressed (consent which is specifically mentioned).  A physician has to obtain informed consent before performing any procedure.

A procedure carried out without the patient’s knowledge, or any deviation in the intervention carried out, without informing the patient amounts to ‘battery’ (a tort of causing harm deliberately).  However, there are certain circumstance under which informed consent need not or cannot be obtained, including public health situations, medical emergencies, incompetence of the patient, therapeutic privilege or a voluntary relinquishment from the patient.

In a public health emergency, consent form the individual is not mandatory as a clash between the patient’s rights and the public rights; would result in the rights of the public prevailing (as more number or people would be affected).  In such emergencies, it may be required to treat or quarantine people, sometimes against their will.

During a medical emergency, consent is usually not required, because in such situations the patient is unable to give one.  Obtaining consent may in fact take a lot of time and may delay life-saving procedures.  Studies have shown that consent obtained from patient’s requiring emergency care often lead to development of fear.  Some people felt that in such situations they were more often left without any choice.  Other studies have shown that physicians are more likely to do something beneficially for the patient, in such situations.

A physician need not obtain consent from a patient, if he perceives that he/she is incompetent to make a decision about their good health.  Treatment provided in such situations would be deemed as ‘in the best interests of the patient’.  In some cases, the patient may have a condition that affects his/her thinking abilities.  However, if the physician feels that the patient’s condition is not going affect his/her decision-making abut health; then it would always be better to obtain prior consent.

Therapeutic privilege is a condition in which the physician need not inform the patient about certain issues in an effort to prevent further harm to the patient.  A physician need not inform the patient if he/she feels that it can cause unnecessary mental tensions.  However, this benefit is often misused by physicians.

Some patients may voluntarily give up their rights to give consent, and instead allow the physician to perform the necessary procedures.  In such situations, informed consent is usually not necessary.

Consent is usually not needed for routine or minor interventions, as the physician may feel that it is usually implied, considering the fact that the patient has come forward seeking medical care.  However, for interventions in which the risks are significantly higher, consent is mandatory.

References:

Akkada, Andrea, Jacksona, Clare, Kenyona, Sara, Dixon-Woodsb, Mary, Taubb, Nick , & Habibaa, Marwan (2004). “Informed consent for elective and emergency surgery: questionnaire study.” BJOG: An International Journal of Obstetrics & Gynaecology, 111(100), 1133.

Foëx, B. A. (2001). “The problem of informed consent in emergency medicine research.” Emergency Medicine Journal, 18, 198-204

http://emj.bmj.com/cgi/content/full/18/3/198