Informed consent is the process of disclosing appropriate information to a competent patient. The patient then, by that information, makes a deliberate choice of either selecting or rejecting treatment. It is also an important document for all surgical and aesthetic measures. Informed consent is related to the legal and ethical rights of the patient. She is the main decision maker regarding what happens to her body. The main purpose of informed consent is to allow the patient to participate in her health care decisions. There must be proper documentation and counseling of patients during the process of informed consent. Almost all healthcare interventions require patients to provide their informed consent.
For this purpose, they fill out a wide-ranging consent form (Vaughn, 2017). If a patient is not informed, she is at risk of making wrong decisions that do not reflect her values or desires. It is also considered a criminal offense if no valid informed consent is included in the medical intervention.
Patients can make their own decisions or not, which are always obvious in all cases. Patients during their illness suffer from enormous stress. They may face anxiety as well as depression. Patients must be assessed properly to ensure they cannot make good decisions (Vaughn, 2017). Decision-making capacity can be judged by different standards. In general, patient ability is judged by three criteria. These include an understanding of the situation, an understanding of the risks adhered to the decision, and communication ability related to the decision.
A 64-year-old patient who has multiple sclerosis (MS) has her brain and spinal cord damaged. She is not in a position to make any decision regarding health interventions, as her underlying disease is damaging her decision-making ability. In the morning, she agreed to a health care intervention, but in the evening, she refused to allow its implementation. She again approved the treatment during her lucid condition and was unable to remember her previous decision. By this scenario, it is clear that she must not be judged competent as, due to her illness, she is not able to provide valid informed consent (Vaughn, 2017). Her final agreement to the procedure is also not sufficient to conclude that she has provided informed consent. But her earlier waffling and confusion must be taken into account. And on this basis, it is easier to state that she has not provided valid informed consent.
Here, federal regulations are allowing using surrogate decision-makers as the patient is unable to consent on her behalf. A legally authorized representative or a surrogate decision maker essentially needs to state for her in this situation as the patient has a neurological disability. This surrogate decision-maker must have a rational awareness of the subject. Different interventions must be used to catch the patient in her lucid condition. Usually, two kinds of surrogate consent laws are renowned: hierarchy surrogate consent laws and consensus surrogate consent laws (Vaughn, 2017). Law provides the basis for a specific hierarchy to be followed here for a decision. The surrogate decision-maker can be a parent or a guardian, and in this type of surrogate consent, there is a very slight emphasis on cooperative decision-making or group decision-making. If there is no surrogate available, physicians are projected to do whatever is in the best interest of the patient. Here, the patient’s consent can be presumed to be in her best interest. With this presumed patient consent, emergency interventions will be used for the prevention of death or disability.
References
Vaughn, L. (2010). Bioethics: Principles, issues, and cases.
