© Springer International Publishing Switzerland 2016
Jesse M. Ehrenfeld, Richard D. Urman and Scott Segal (eds.)Anesthesia Student Survival Guide10.1007/978-3-319-11083-7_3232. Ethical and Legal Issues in Anesthesia
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Vanderbilt University School of Medicine, Nashville, TN, USA
Jesse M. EhrenfeldAssociate Professor of Anesthesiology, Associate Professor of Surgery, Associate Professor of Biomedical Informatics, Associate Professor of Health Policy, Director Education Research
Keywords
EthicsInformed consentLegal issuesMalpracticeAdvanced directivesFor maximum impact, it is recommended that the case study and questions found on page xxxiv are reviewed before reading this chapter.
Key Learning Objectives
Understand the principle and process of obtaining informed consent
Learn the definition of medical malpractice and how to avoid frivolous claims
Know the procedure for addressing DNR/DNI status in the operating room
Informed Consent
Informed consent is a process in which a patient makes decisions and gives consent for procedures and treatments after having achieved a clear understanding of the facts and implications of taking a particular course of action. Contrary to popular belief, informed consent is a process – not just a signed legal document.
Informed consent is only possible when a patient is both (1) able to make rational decisions and (2) has received all of the relevant facts. Typical discussion points should include diagnosis, purpose of the therapy, possible risks and benefits, potential alternative therapies, and risks associated with not receiving the therapy. The process is summarized below.
Guide to Obtaining Informed Consent
Informed consent is a process – not a signed document
Informed consent should be obtained prior to administering sedatives
The patient may accept/refuse any treatment (principle of patient autonomy)
The patient should receive a description of procedure, potential risks and benefits
Incapacitated patient (altered consciousness, incompetent, disabled)
does not have the ability to provide consent
next of kin or a healthcare proxy should provide consent instead
If obtaining consent via telephone, make sure to obtain a witness
Under emergency, life threatening situations, consent is implied and may be waived
Use an official hospital interpreter for non-English speakers whenever possible
Pediatric patients and minors (<18 years of age) cannot give consent for themselves (except pregnant patients in some states)Related posts:
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