What is informed consent in healthcare?
You have the right to fully understand and agree to any medical procedure or treatment you receive before it proceeds. Informed consent is your understanding and agreement. Your healthcare provider is responsible for effectively communicating with you about your condition and your testing and treatment options. They must obtain your informed consent before proceeding with any option.
Informed consent is one of the nine core principles of the American Medical Association’s Code of Medical Ethics. Opinion 2.1.1 in the Code of Medical Ethics states, “Informed consent to medical treatment is fundamental in both ethics and law. Patients have the right to receive information and ask questions about recommended treatments so that they can make well-considered decisions about care.”
Informed consent is an ethical concept first, a legal concept second, and finally, a formal administrative process. In the United States, informed consent laws vary by state and by circ*mstances. Some cases require a signed document indicating your informed consent, while others only require a verbal agreement. But in all cases, healthcare providers have to keep some record of the process.
Why is informed consent important?
Consent codes and laws protect both caregivers and care receivers. They help establish trust in your caregiver while respecting your autonomy as a care seeker. They help to prevent misunderstandings and lapses in communication that could lead to you being unhappy with the care that you receive. They make sure that you understand what to expect, including the chances of less-than-optimal outcomes.
Most healthcare providers have good intentions to treat care seekers ethically, including being honest about their options, their risks and their prognosis. But sometimes practical limitations and human error thwart these intentions. That’s where formal processes and laws can help. These processes and laws have evolved over time to take into account some of the stumbling blocks we’ve met along the way.
For example:
- What if you and your healthcare provider don’t speak the same first language?
- What if they’ve given you information in writing, but it reads like a medical textbook and you find it hard to grasp?
- What if you’ve agreed to have a procedure at a teaching hospital, but you didn’t realize students or residents would be involved?
Scenarios like these have required healthcare providers to revise their approach.
Which medical procedures require informed consent?
Laws vary, but in general, informed consent applies whenever you’re accepting a risk. Many medical procedures carry a low risk of complications or a moderate risk of minor side effects. In addition to protecting your body, you also have the right to protect your privacy. The principles of informed consent protect all of these rights. In practice, procedures that are likely to require signed consent include:
- Treatment with high-risk medications, such as opioids.
- Tests and medical interventions that go inside your body, such as endoscopy.
- Childbirth interventions, such as forceps delivery or episiotomy.
- Surgery.
- Biopsy.
- Medical implants.
- Use of anesthesia.
- Use of radiation.
- Chemotherapy.
- Blood transfusions.
- Genetic testing.
- Clinical trials involving human research subjects (including psychology research).
- Procedures involving medical students.
- Certain vaccines.
- Any transfer of your personal information.
What are some examples of informed consent in healthcare practice?
- Treatment planning: You’ve just learned that you have cancer, and based on the type and stage that you have, there are a few different treatment options. All of the options have different risks and side effects. Your doctor recommends one option, but you read about an alternative treatment that interests you. It’s your doctor’s job to explain their opinion while also fairly addressing your concerns and personal preferences. This is how both of you can cooperate in the decision process.
- Unplanned interventions: You’ve been in labor for several hours, but labor isn’t progressing. You didn’t want medical intervention, but now your healthcare team is telling you that they’re concerned for you or your baby. There are a few different ways they could intervene to assist you, but they will have to act quickly if they do. All options have risks, including not intervening. Your team will explain your options and their recommendations so that you can decide how you want them to proceed.
- Authorized consent: You’ve been diagnosed with a complex condition that you’ve never heard of before. Your doctor has explained it, but you find the details confusing and overwhelming to consider. You don’t really want to become an amateur researcher or second-guess your doctor’s judgment. You just want to trust your doctor to take care of it for you. You can authorize this. They’ll tell you what they want to do and why, but you can request minimal details and decision-making.
