Consent refers to the provision of approval or agreement, particularly and especially after thoughtful consideration and understanding. Consenting is one of the critical matters in the area of medical treatments.
“Consent is a legal requirement of medical practice and not a procedural formality”. Getting a mere signature on a form is no consent. If a patient is rushed into signing consent, without giving sufficient information, the consent may be invalid, despite the signature.
How consents came into hospital picture:
The Nuremberg Code (a set of research ethics principles for human experimentation) was adopted immediately after World War II in response to medical and experimental atrocities committed by the German.
The code makes it mandatory to obtain the voluntary and informed consent of human subjects. Then Medical Council of India introduced the consenting system for both medical practitioners & patients
What does it actually mean?
A patient who comes to a doctor for treatment implies that he/she may be agreeable to a general physical (not intimate) examination. So, Consent must be obtained prior to conducting any medical procedure on a patient.
Types of Consent:
Informed Consent, Expressed Consent, Implied Consent, Surrogate Consent, Advance Consent
Common consents available in the hospital:
Admission Consent, Surgery & Anesthesia Consent, High-Risk Consent, Blood Transfusion Consent, etc., are some of the common consents are available in the hospitals.
Contents of the Consents:
- Condition of the patient
- Purpose and nature of the intervention
- Consequences of such intervention
- Any alternatives available, Risks involved
- Prognosis in the absence on intervention, The immediate and future cost
What patient rights & responsibilities charter states ?
The information to be provided to patients are meant to be & in a language of the patient’s preference and in a manner that is effortless to understand.
Patients have to be educated on risks, benefits, expected treatment outcomes and possible complications to enable them to make informed decisions, and involve them in the care planning and delivery process.
Current State of Receiving Consents: Not educating the patient accurately, filling up Consents with no Date, Time & Signature (both parties), Making Patient Perception, Creating False Expectations, Poor Documentation & No Clarity / Transparent communication at the timing of explaining the Hospital process.
How those forms should be maintained:
The Primary Consultant is the key person who has to oversee this process and is primarily responsible for Consent forms, treatment plans, operative records, medications used, referral papers, discharge records, and medical certificates.
It’s essential to implement a proper process for storing, analysing & retrieval of patient records especially in the large numbers of smaller clinics and hospitals that cater to a large section of the people across our country.
It is important for the doctor and medical establishment to properly maintain the records of the patient for 2 important reasons.
First one is that it helps in proper evaluation of the patient and to plan treatment protocol.
Second is that the legal system relies mainly on documentary evidence in cases of medical negligence.
Therefore, medical records including hospital consents should be properly written and preserved to serve the interest of the doctor as well as his patient.
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