Obtaining a patient’s participation in medical treatment can be essential to achieving a successful outcome from the patient’s point of view. Patient participation can more easily be obtained through the informed consent process. The core of the informed consent process is the health care provider’s transfer of material information about the risks and benefits of a proposed treatment to the patient, including information about the risks and benefits of non-treatment. This can be especially important in the case of prostate cancer, as an example, where a patient might well prefer “watchful waiting” to one of the other modes of treatment.
Notice the word “process” in the phrase “informed consent process.” That word is used purposefully. Informed consent is all about process; it’s not just a form, although the fact that the process occurred may, but is not legally required to, be evidenced by a written form.
Informed Consent must be informed to be meaningful
And, notice also the word “informed.” It, too, is used purposefully because more than mere consent, or a refusal to consent, to treatment is required. For the transfer of information to be informed, as well as meaningful, and to be truly respectful of the patient’s right to the information, that transfer must be done in a way that the patient comprehends and, at least morally, in a way that best guarantees the patient understood the information. Thus, the information transfer should occur at a time when the patient is receptive to hearing the information and is in a frame of mind that would allow the patient to participate in a conversation about that information. Otherwise, the process is reduced to a meaningless formality that fails to recognize the patient’s right to participate in medical decisions affecting the patient’s life and medical well-being.
The process of obtaining the patient’s informed consent, when followed by the decision of the patient to accept or reject the proposed treatment or non-treatment, goes a long way in assuring the patient’s “buy in” to any subsequent care provided to the patient, thus, in my view, improving the quality of care that the patient receives.
Sheldon F. Kurtz
David H. Vernon Professor of Law
University of Iowa College of Law