Informed Medical Consent

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We take a look at the vexed issue of medical consent from a personal perspective

The son of one of our lawyers recently needed some fairly radical emergency treatment at a Devon hospital after an unfortunate accident on a farm. When the time came for him to be wheeled into operating theatre, she was asked to sign the inevitable consent forms. She stood there, pen in hand, whilst the gowned surgeon sharpened his tools and his team busily prepared for the operation to be performed. As a litigation solicitor specialising in clinical negligence she should have been better prepared than most, but it’s difficult to remain cool, calm and collected when it’s your own child who’s about to go under general anaesthetic. And it wasn’t made any easier by the fact that all three of her young sons have needed hospital treatment in recent years, each one requiring consent forms to be signed.

A number of her friends have asked her what sort of reaction she gest from hospital staff when they find out she is a lawyer in a law firm specialising in medical negligence claims. The truthful answer is that she doesn’t know because she always avoids the question at all costs. she doesn’t think it would be terribly relaxing if the surgeon knew what mum’s day job was. There is enough pressure on the medical team without them wondering what she would do if they messed up!

In reality most parents and patients sign the consent forms with barely a few moments’s thought, especially in an emergency situation, and on this occasion she was no different. After all, without consent being given the treatment cannot proceed and she didn’t want to do anything that might hold things up. All healthcare professionals need the patient’s consent (or if it’s a child, their parent’s consent) before they can administer treatment. Consent is normally provided verbally but when a patient needs to undergo an invasive procedure or surgery when they will be under an anaesthetic, they will be asked to provide consent in writing.

There is more time for reflection on non-emergency situations, so when the registrar or surgeon comes to pay his bedside visit to go through the forms, the astute patient would be right to ask, `What does this involve? What exactly am I consenting to?’ In many instances the answer to these questions will be self apparent and the patient will have no choice in practical terms. In other cases the risks might need to be weighed more carefully before consent is given. It is so important that these issues are properly considered because if things do go wrong, the consent form is one of the documents that the lawyers will call for.

Anyone who finds themselves in hospital and requiring surgery should think carefully about the form they are presented with and the implications that a simple signature can have. The consent form should stipulate the procedure that the patient is about to undergo, who is performing it and the risks involved with the proposed operation or procedure. Patients should make sure they read the form and ask questions about what could go wrong. Unless you are absolutely certain about what is involved, don’t do as I did and just sign the form without a second thought. Nor should you be afraid to ask about the success rate of the procedure. Make sure you find out what other options are available. Question the health professional about contingencies if things don’t go to plan. What is the worst case scenario? Would you be happy for them to continue to remove your one good kidney if they messed up repairing the other one, for example?

It is important to bear in mind that if you have not been given sufficient information to provide what is termed ‘informed consent’, serious ethical issues arise. So if you find yourself in hospital and the person with consent form comes calling, don’t be tempted to pick up the pen and sign on the dotted line without proper consideration of the risks.

If you wish to discuss the issue of informed consent then please feel free to give us a call on 0808 139 1606