Thursday, January 30, 2014


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To obtain a legally effective informed consent from a patient for a procedure the patient ought to be told in terms that he understands:

  • Diagnosis

  • Procedure or Treatment

  • Risks and Consequences

  • Feasible Treatment Alternative

  • No Treatment Outcome

The difference between ‘risk’ and ‘consequences’ is significant.  A risk is something that might happen, such as an infection.  A consequence is something that will happen.

Informed Consent is not a form.  A form signed by the patient may serve as evidence that his consent to the procedure was obtained, but valid informed consent is a process in which the physician makes sure the patient under stands the material facts he needs to make a sound decision whether or not to accept the procedure.  It is more than prudent to chart informed consent rather than rely solely on an office form.  If a patient is reluctant to sign a form but consents to the procedure then charting informed consent should be adequate.

Do not use ‘Informed Consent’ when a patient insists on alternative medicine.  Use ‘Assumption of Risk’ as discussed in a later post.


  • Emergencies

  • Unconscious or Incapacitated Patient

  • Patient Waiver


If a patient must give his consent to a medical procedure before it can be performed, it follows that a patient who is a competent adult also has the right to refuse treatment.  Doing an invasive procedure that a competent adult has refused is a battery, a tort for which the physician can be sued and which may not be covered by his malpractice policy.

The Supreme Court case of Cruzan held, among other things, that a competent adult has the right to refuse medical treatment including artificial nutrition and hydration.

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