Ethics & Communication

Question 1

For an informed consent to be ethically acceptable, there are conditions that it should fulfill. These conditions are

Answer 1

capacity, disclosure, and voluntariness.

Question 2

6-step protocol, referred to as the SPIKES Protocol for Delivering Bad News
Which are

Answer 2

Step  1.  S  -  SETTING  UP
Step  2.  P  - PERCEPTION
Step  3.  I  - INVITATION
Step  4.  K  - KNOWLEDGE
Step  5.  E  - EMOTIONS  with  empathetic responses   
Step  6.  S  -  STRATEGY  AND  SUMMARY

Question 3

Defined as any event that could have had adverse consequences but did not and was indistinguishable from fully fledged adverse events in all but outcome

Answer 3

Near-miss (Some studies use the related terms “potential adverse event” and “close call.”)

Question 4

the informed consent involves informing the patient about

Answer 4

the diagnosis, degree of certainty regarding the diagnosis, the surgery that would be recommended in that case and possible alternatives along with their expected outcomes, risks and benefits. The patient outcome, if no therapy is administered must also be explained to the patient.
The patients must also be informed about the advantages, disadvantages, success and failure rates, and complications of the various procedures. The patient must be counselled even regarding the rare complications that are serious and may affect the individual’s life.

Question 5

The informed consent requires the presence of following pieces of information:

Answer 5

nature of the procedure; rationale of doing the procedure; advantages and disadvantages of doing the procedure; and availability of alternatives.

Question 6

The elements of informed consent are as follows:

Answer 6

■ Disclosure of information
■ Comprehension by the patient
■ Voluntary transaction
■ Validation

Question 7

Types of Consent:

Answer 7

• Implied Consent
• Verbal Consent
• Written Consent

Question 8

Bolam vs. Bolitho principles

Answer 8

“Bolam principle” relating to whether a doctor’s actions had beenreasonable. A doctor’s behaviour would be judged legal if a substantial body of his/her peers would have behaved in the same way as the doctor had done. In the “Bolitho case”, the judge took the view that it was for the court to decide what was reasonable behaviour, not the medical profession. In other words, the court could dismiss the views and practices of this “substantial body of peers” as wrong.