The word consent in medical terms means a voluntary agreement by a fully informed, competent patient to a form of treatment or investigation (UK clinical Ethics 2003)). The general meaning of informed consent can be described as a legal condition where a person can be said to have given ‘consent’ due to a positive reception and understanding of the facts and insinuation of an action.
In order that the informed consent is appropriate to the individual who is being consented should be mentally sound in way that he is not mentally retarded or mentally ill or not in proper state to make the consent at the time of consenting such as being ill, intoxicated, drunk, insufficient sleepy and other health problems. Although it has been identified in the definition of informed consent, that it is necessary to be taken but there are some sound reasons where it is advisable not to seek such consent.
The examples of such situation where it is advised to refrain from taking consent are research with incompetent patients; research using anonymised tissue samples, and certain types of epidemiological research (Dawson, 2004). On the other hand implied consent is the kind of consent in which the patients who are not able to or not in a state to give consent are given treatment under the lawful assumption that he or she would want treatment and it would be beneficial for her or him .
Problems patients have with understanding what they have consented too. There are certain serious problems that arise while patients consent. There are certain situations in which the patients make false assumptions about a certain medical procedure they are going through. Sometimes they fail to remember all the details of the consent or do not completely understand the method of treatment, prognosis, and conditions. For an effective relationship between the patient and the doctor, proper communication is necessary.
If the patient and doctor are not able to exchange their views properly, and the patient is not able to understand what he has consented to it can result in decreased diagnostic powers, which may further cause physicians to defensively order unnecessary, hazardous, or expensive diagnostic tests, or may make physicians less likely to order needed tests. Patients who do not understand their physicians and who do not completely understand what they consented to are less prone to take medication as directed, follow instructions, and keep medical appointments.
Hence to avoid such complications, the doctors should emphasize on the following before a patient consents: -Doctors should allow the patients to take active part in health maintenance long before they seek medical care. The main objective of the fluctuating patient behavior should be taken more than the individual health behavior change toward a change in an individual’s negotiating behavior.
When a patient is in the process of consenting, the patient develops his or her skill of exchanging thoughts and doubts; this can be enhanced by the provider or the doctor by communicating actively and effectively with the patient and guiding him to apply these skills in interacting in understanding with the medical system or procedure. -Patients should be familiar and updated with all the important details regarding their medical care.
-The providers should critically evaluate their own assumptions and fundamental concepts about what they think is a ‘good’ patient and then consider the effect of these assumptions and values on their communication strategies. The ability to provide good healthcare can be enhanced by the effective exchange of views about a medical procedure between a patient who is going to consent and a doctor. -The change in the behavior of the patient in the medical interaction should be the result of a process of negotiation between provider and patient.
The medical provider does maintain standards of best treatment and advice to provide to the patient. The goal of the process of consenting is participatory decision making, which combines the patient’s value system, opinions and understanding with the professional evidence provided by the doctor, hence the patient is completely familiar with the further implications of the consent and hence there is a very minimum level of conflict after the procedure has been performed.
-The medical system should focus on community empowerment in addition to individual empowerment (Bocanegra, Gany, 2004). Are patients allowed to withdraw their consent after a procedure is performed? The question above can be related to the incident, which occurred recently and made legal history. This incident included a ‘tetraplegic’ patient who was the first person to successfully apply to the High Court to have her life prolonging treatment, in the form of artificial ventilation, withdrawn.
It has been described many a times in the study of ethics and law that competent adults who have the capacity to comprehend their consents, possess the right to refuse any medical treatment even if that refusal results in their death. There are certain situations when doctors do not approve of patients who withdraw active treatment when the patient is competent, informed, and requesting such a course of action (Goldie, Schwartz, Morrison, 2004).
Hence it is made clear that, If the patient is definite about withdrawing from the consent and does not wish to proceed, the practitioner is legally required to stop, but only if there are medically viable options or the procedure can be stopped without detriment to the patient’s health or life. These conditions must be weighed seriously because patients do seem to have a right to withdraw consent, even after a procedure has begun (Murphy, 2003).
Bibliography
Bocanegra,H. Gany,F, 2004. Good Provider, Good Patient: Changing Behaviors to Eliminate Disparities in Healthcare. The American Journal of Managed Care, Special Issue Page, SP020-SP028 Angus J Dawson (2004). Methodological reasons for not gaining prior informed consent are sometimes justified. BMJ Journal, Issue: Summer, 2004. Volume 329 page 87 Goldie, J; Schwartz, L; Morrison, J, 2003 Students’ attitudes and potential behavior to a competent patient’s request for withdrawal of treatment as they pass through a modern medical curriculum. Journal of Medical Ethics. Volume 30 Page 371-376 UK clinical ethics network (2003) Consent.