Informed consent

Devlin, a research assistant in the Office of the General Counsel of the American Medical Association, responds to a physician's question about the validity of the consumer advocacy interpretation of informed consent as requiring that the physician not seek to influence the patient's decision. She responds that the physician is obligated to make recommendations in accordance with good medical practice.     

Informed consent in renal transplantation

Purpose: This study was performed to assess how well completed the new consent forms are for patients undergoing renal transplantation. Methodology: 100 patients were randomly selected from the 160 who had a renal transplantation, at a single centre in the UK, over an 18 month period. The notes were located and the consent forms scrutinised. Findings: Seven sets of notes could not be traced and 10 did not contain a relevant consent form. Forty eight per cent of completed forms mentioned the source of organ while 8% mentioned on which side the operation was to be performed. Twelve risks and complications were identified as being relevant to this procedure but no single form mentioned all 12. In most cases a senior member of the surgical team obtained consent. Implications: The demonstrated variability in the amount of detail on consent forms lends weight to the call for the use of procedure specific forms. While such variability does not necessarily equate with not gaining valid, informed consent, this form, at present, serves as the only record of what has been discussed with the patient. These findings should encourage all surgeons to complete the forms themselves, be as detailed as possible, and ensure that the form is filed in the patients'' notes.     

Informed consent for blood transfusion

At present, few institutions consider separate informed consent for blood transfusions; rather, the patient gives this consent as part of a more comprehensive statement. This should change in the era of increasing patient's rights. The physician has the moral duty to fully inform the patient of the risks and benefits involved in the planned therapy. A separate consent requires time and paperwork but if done properly, it benefits the patients by increasing their knowledge and autonomy in the transfusion process.