In this episode of Dr. Lawyer Breakdown, Dr. Joseph Ramos examines one of the most misunderstood concepts at the intersection of medicine and law: informed consent. Drawing on his experience as a practicing emergency physician and attorney, Ramos explains that true informed consent involves more than signing a form or being told about the risks of a procedure. Patients should understand the risks and benefits of treatment, the risks and benefits of not receiving treatment and available alternatives. He also discusses why informed consent is often handled much more quickly in clinical practice than the legal definition might suggest and why patients should ask questions when they do not understand what they are being asked to consent to.
The conversation also explores informed consent in emergency situations, including implied consent when a patient is incapacitated and the importance of advance directives, DNR orders and medical powers of attorney being accessible. Ramos explains how pain, medication, urgency and a patient’s capacity can affect the consent process. The episode also examines the difference between an accepted risk of a procedure and medical negligence, including situations involving inadequate sterilization. Finally, Ramos discusses challenging consent situations involving adolescents and parents and previews Part 2, which will examine the legal cases that helped shape informed consent.
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What Informed Consent Really Means: 6 Key Takeaways
- Informed Consent Goes Beyond a Signature: True informed consent involves understanding the risks, benefits and alternatives of treatment rather than simply signing a form.
- Patients Should Understand Both Sides of the Decision: Consent should address the risks and benefits of undergoing a procedure as well as the risks and benefits of not undergoing it.
- Patients Should Ask Questions Before a Procedure: Dr. Ramos encourages patients to make sure they understand what is being done, why it is being done and what alternatives exist before they are in a stressful preoperative setting.
- Teach-Back Can Help Confirm Understanding: Dr. Ramos describes having patients explain a procedure back to the doctor as a useful way to determine whether they actually understand what they have been told.
- Emergency Treatment Can Involve Implied Consent: When an incapacitated patient needs immediate emergency treatment, physicians may rely on implied consent to provide necessary care until they learn otherwise through reliable information such as an advance directive or DNR order.
- An Accepted Risk Is Not the Same as Negligence: A complication such as an infection may be a known risk of surgery, but evidence that a provider breached the standard of care, such as through inadequate sterilization, can change the legal analysis.
