Consent

Consent is not always written.

• Implied consent (most common form) can be demonstrated by offering an arm to check blood pressure or opening the mouth for a throat culture.
• Express consent can be obtained orally or in writing when there are many risks, consequences, and alternatives to a proposed procedure. The Patient Self Determination Act of 1990 protects patient rights, including the right to agree to or refuse medical treatment. To enable the patient to decide, the physician has the duty to explain to the patient all the information necessary to clearly evaluate the proposed treatment (called the Doctrine of Informed Consent).
• Informed consent requires making the patient aware of the nature of his condition and the purpose of a proposed procedure, benefits and risks, and alternative treatment options. This must all be understood by the patient before any treatments are done. It is the physician’s responsibility to ensure that language barriers do not impair the communication.

If the treatment information is upsetting to the patient, it is his right to decline the treatment. Oftentimes, however, the process simply requires answering additional questions by the patient and/or family members. When all concerns have been answered, the patient must sign and date the informed consent. The physician and a witness must sign the consent.

Confused patients who are not incompetent have the right to sign consent, but many prudent physicians will want a family member to sign the consent as well. Patients always have the right to rescind any permission or consent given. The medical assistant’s role in informed consent is to witness the signature.

Do not confuse consent issues with offering emergency care to an injured person. Emergencies can occur where a patient requires immediate medical attention. Health care workers are often afraid to perform first aid because of the Doctrine of Informed Consent, but it should be known that the Good Samaritan Act protects the actions performed by health care persons who act in an emergency situation outside of the health care facility, as long as they act within the scope of their training. Make sure your state carries a Good Samaritan law.