Autonomy And Informed Consent Flashcards
The concept that patients are to be treated as individuals and informed about procedures to facilitate appropriate decisions.
Autonomy
Autonomy is the…
…right to self-determination
The written asset of a patient to receive a proposed treatment; adequate info is essential.
Informed consent.
The individual giving consent must fully understand:
- the nature of the procedure
- risks/complications/side effects
- desired outcome
- possible alternatives
A copy of this is given to patients to help them understand the expectations, rights, and responsibilities regarding their health care.
Patient Care Partnership
Expectations
- high quality care
- clean and safe environment
- involvement in their care
- protection of privacy
- Preparing patient & family for discharge
- help with their bill and insurance
High quality hospital care
Care delivered with skill, compassion, and respect
The way info is given depends on the criteria used to inform the patient.
4 possibly conflicting rules that may guide the care provider in explaining info to patients.
Information delivery.
4 conflicting rules to information delivery
Patient preference rule
Professional custom rule
Prudent person rule
Subjective substantial disclosure rule
Requires health care professionals to tell their patients what they want to know.
Patient preference rule
States that the health care professional should give the patient the info normally given to patients in similar situations.
Professional custom rule
Measures the healthcare provider’s disclosure to the patient based on the patient’s need for info to make decisions regarding treatment.
Prudent person rule
Encourages the physician to disseminate ALL info important to the individual patient.
Subjective substantial disclosure rule
Provides info without overburdening the patient
Combination of rules
Ensures principle of pt. autonomy
Must respect pt’s choice to refuse treatment
Must inform pt. that they have the right to refuse surgical care
Patient Self-Determination Act of 1991
The ability to make choices
Necessary element in informed consent
May be compromised, temporarily or permanently
Competence
A person who substitutes for another, often in the decision-making process.
Surrogacy
Difficult to prove
Incompetetnce
Obstacles to autonomy & informed consent
Family or physician pressure Coercion Paternalism Language and culture Lack of time Lack of communication
Forcing the patient to act or think in a certain way by applying pressure or threat to control
Coercion
A narrowly construed prerogative invoked when health care providers withhold info from patients because they believe the info would have adverse effects on the patients’ condition or health
Therapeutic privilege
Emergency situations
3 conditions must present:
1 patient is incapable of giving consent, and no lawful surrogate is available.
2 danger to life or risk of serious impairment to health is apparent
3 immediate treatment is necessary to avert these dangers
Predetermined choice made to inform others of the ways in which the patient wishes to be treated while incompetent
Advanced directives
A civil wrong for which law provides a remedy
Tort law
2 categories of tort law:
Intentional torts
Unintentional torts
Result when act is done with intention of causing harm to another
Intentional torts
Intentional torts most likely to impact medical imaging services:
Assault
Battery
False imprisonment
Defamation
The assent required of a patient for any procedure
Doesn’t require knowledge of the procedure
Simple consent
A deliberate act wherein one person threatens to harm another without consent and the victim feels the attacker has the ability to carry out the threat
Assault
Touching to which the victim has not consented, even if touching would benefit the patient
Battery
The unlawful confinement of a person within a fixed area
False imprisonment
Wrongs resulting from actions that were not intended to do harm
Unintentional torts
All of these are based on the fact that duty is owed, the duty was breached, and harm resulted from the breach of duty
Unintentional torts
Two basic exceptions exist in which informed consent not be obtained
Emergency situations
Therapeutic privilege is invoked
A consent form must never be used in place of an oral explanation
Consent forms
Consent form includes:
Name of procedure Explanation of procedure (risks/benefits) Space for patient name Name of person doing procedure Signature lines
Consent should be obtained within ____ hours before the procedure
24
Written consent must always be obtained when doing __________ procedures.
Invasive
