Informed consent is an important aspect of medical practice; however, in a clinical setting, busy doctors may take it as routine and overlook its rich value. Every procedure or surgery is carried out based on the informed consent of the patient and involves an elaborate process. The patient must be made aware of, and understand, the procedure or surgery being done on them and the reasons, as to why, it is being done to them. Many medico-legal disputes arise, not because the treatment carried out was inappropriate, but because the patient felt that they were not adequately informed. Dr Vimal Kant Goyal, a renowned medico-legal guide in Delhi states, Informed Consent is the starting point of providing ethical and legal medical care.

The Components of Informed Consent 

Being informed means the patient understands the diagnosis, the reason for the procedure, the potential complications and risks, the expected outcome and other options available, including no treatment. The clinician must also outline the likely consequences of the decision not to proceed. Consent is said to be valid and legal when it is given apart from duress and, at the same time, in the presence of a decision-making capacity. 

In this case, effective communication means that the physician does not use words that are overly technical. The use of plain language also helps to inform the patient and, thus, reduce the risk of litigation.

Why Informed Consent Matters for Doctors

From a legal standpoint, informed consent protects a physician's right to defend themselves against an allegation as a result of the patient being a part of the decision-making. Patients that have instituted lawsuits against physicians have been successful due to the courts deciding the patient was not sufficiently informed about the potential benefits, risks, and alternatives of the procedure and the legal case, and the medical case, ended unfavorably for the physician. In cases where consent was either not obtained or poorly documented, the physician will become the subject of an unjustified criticism. In other words, if the physician performed the right procedure, he or she will face criticism as a result of the physician's documented decision to leave consent out of the case, even if it is in reality correct.

Dr Vimal Kant Goyal, who is a medico-legal guide in Delhi, states that not having proper consent is one of the most prevalent reasons why doctors find themselves being sued.

Every Day Obstacles

Due to time constraints, doctors cannot always provide detailed explanations that result in the order of appearance being influenced or, in the case of obtaining actual consent, that the physician had to cut off the patient and had to delegate the responsibility of explaining the risks to someone else. This is a case that, unfortunately, suffered an unexplained risk.

It is virtually impossible to rely on something other than verbal acceptance for it, since it is otherwise in a situation that could arise in one of the potential areas of significant risk and legal liability. Verbal acceptance alone is not a sufficient basis upon which to rely, although there is a situation in which it may be an acceptable basis.       

Making Consent a Practical Process

Informed consent is a practical process. Doctors can and should explain each step of a process in a manner in which the patient can understand, explain risks, and the many ways the procedure can be performed. Paperwork is always a part of the process, but real consent occurs when the patient and/or the patient advocate understands the full scope of the procedure, the rationale behind the procedure, and the risks of the procedure. Documentation should be thorough.

Consent in Special Situations

Special considerations should be made for emergencies. Unconscious and minor patients. Emergencies do not require consent, but the rationale must be clearly documented. Consent for minors must come from a parent/guardian, and a rationale should be provided.

Rationale must always be provided when the patient is unable to participate in clinical decision-making to justify the choices made to account for the gaps in patient advocacy.

Conclusion

Informed consent is more than documentation; it is part of the many ways a physician can prove their professionalism. Each time a physician explains and documents a consent, the physician is decreasing their risk of being sued and increasing their own professionalism. Each time a physician explains and documents a consent, the physician is increasing the risk to the patient and the patient's advocates, and the clinician themselves to be sued, and increasing the clinician's professionalism.