Patient autonomy and informed consent

Chapter 4

Autonomy

the right of self determination

Informed consent

Written agreement of a patient to receive a proposed treatment

the pt giving consent must fully understand….?

nature of procedure, risks involved, desired outcome, possible alternatives

patient care partnership

helps pt’s understand the expectations, rights, and responsibilities regarding their health care

who created the Patient care partnership

American hospital association (AHA)

Expectations of PCP

High quality hospital care, right to know , clean and safe environment

Information delivery

the way info is given based on criteria used to inform pt

4 conflicting rules that may guide the care provider in explaining information to pt’s

Patient preference, professional custom rule, prudent person rule, subjective substantial disclosure rule

patient preference rule

HCP to tell pt what they want to know

Professonal custom rule

HCP gives pt the information normally given to pt’s like they would any other

Prudent person rule

provider gives enough info that pt can give consent but won’t freakout

Subjective substantial disclosure rule

encourages provider to tell ALL important info to pt

What is the self determination ACT of 1991?

lets the pt know they have to right to choose or refuse treatment.

Who is responsible for informed consent?

Physician

simple consent

consent required for procedure, does not require knowledge of procedure

Elements required for informed consent

given voluntarily, competent adult, parent of minor must sign, signed witnessed dates

Competence of patients

ability to make choices

surrogacy

a person who is chosen to make a decision for someone who can’t

Obstacles to autonomy and informed consent

Language, lack of time, lack of communication

Therapeutic privilege

withhold info from pt bc they believe it had better affects

when does informed consent not matter?

emergency situations

3 conditions that must be present in emergency situations

pt incapable of giving consent and no surrogate available, danger to life, immediate treatment is necessary

Advanced directives

predetermined choice made to inform others of pt’s wishes

3 theories

Utilitarianism, deontology, virtue ethics

Tort law

a civil wrong

2 categories of tort law

intentional and unintentional

Intentional vs unintentional tort law

Intentional= assault and battery

Unintentional= negligence commission or reasonable care ( not reason for it)

obtaining valid consent

consent must be given voluntarily by a competent adult

How long is written consent valid for?

60 days