It’s rare to come across someone who refuses to hear information that is offered. In general, people want to know everything—whether it is ordinary gossip or their medical conditions. Therefore, there are many patients who desire informed consent because they want to know the details and reasons behind the medication they are assigned to take.
Informed consent is when a physician is “obligated to obtain the patient’s consent” and to “disclose relevant information about the treatment before obtaining consent and beginning treatment” (Lidz et al, 299). However, nowadays, the doctor-patient relationship gap has widened and, as a result, there’s a lack of communication between the two. So, “physicians do not often fully inform” and “patients do not fully understand” because the doctors don’t have the time and/or desire to make those connections with their patients (Lidz et al, 299). So, while the patients should have an input on their medical decisions, it’s really the physicians who make them (Lidz et al, 299).
Time is of the essence. The time the physician has with his patient is limited, so the medical situations are treated as an event as opposed to a process. Lidz and his colleagues said: “medical decisions are processes that emerge and evolve over a period of time, not discrete events that occur only once” (Lidz et al, 300). However, usually, informed consent is given to a patient at a time where the medical decision is already made. For instance, when I was a freshman in high school, I needed knee surgery. I did not know what the surgery entailed until that day. I had an idea of what anesthesia was but I didn’t know exactly how it worked until I was about to go into the surgery room and my anesthesiologist started explaining to me what was going to happen. I remember thinking how fast-pace the process was. While she put the IV in me, she quickly asked me questions about any allergies to anesthesia and quickly explained to me how the medicine worked and how my body was supposed to react. At this point, I was already going into the operating room and even if I did not want to, I had to go through with it.
Though this example may be miniscule, I think it’s extremely important for one to be informed about their medical situation if they want to be. Though time is the main issue, I think it’s important for the physician himself to, at least, summarize a patient’s situation and give him or her a broad idea of the medication the physician is giving them. Additionally, it may be necessary to even discuss the side effects or why alternative medicine is or isn’t possible. However, unfortunately, physicians don’t think that informed consent is an “integral part of good patient care” (Lidz et al, 303) so they don’t make it a point in their limited time to discuss medical details that, perhaps, they should share with their patients.
Patients should be informed. Though the physician should share information, I think it’s up to the patient to ask questions so that they are knowledgeable and, therefore, make decisions for themselves. In The Place of Autonomy in Bioethics, Childress says that the principle of respect for personal autonomy includes being competent, informed, and acting voluntarily (Childress, 309). We should want to have respect for our personal independence by being knowledgeable.
Lidz, Charles W., Meisel, Alan, Osterweis, Marian, Holden, Janice L., Marx,
John H., Munetz, Mark R. “Barriers to Informed Consent.” Arguing
about bioethics. London: Routledge, 2012. 299-307. Print.
Childress, James F. “The Place of Autonomy in Bioethics.” Arguing about
bioethics. London: Routledge, 2012. 308-316. Print.
5 thoughts on “Knowledge is Power”
You make the point that “physicians don’t think that informed consent is an “integral part of good patient care” (Lidz et al, 303) so they don’t make it a point in their limited time to discuss medical details, that perhaps they should share with their patients.” I think it is important to take into consideration what exactly the care is and what the patient wants out of their experience. Some patients feel as if the doctor has the best interest in them and will do what is needed for treatment, they might not want the extra convoluted, medical information from the physician. Physicians may see this disclosure as a waste of time and something that takes away from the treatment process as whole. I think doctors have this view because typical procedures and techniques have been backed-up over years in the medical community. They have evolved to reduce risks, ease pain and eliminate side effects. Doctors have their trust in these procedures, just like patients have trust in their doctors. Perhaps this is why doctors do not execute the informed consent doctrine to its fullest.
I really enjoy your take on informed consent. Many situations in the hospital do not truly allow the physician to speak and fully explain medical risks or benefits of a procedure or medication. I had a friend who was in the hospital and she had a plethora of medicines, treatments, and other things thrown at her and it was as if her decision to accept these drugs was already assumed. It is as if the doctor feels informed consent begins when the patient walks through the door.
Which essentially it does. As soon as you walk into the door, especially in the emergency room or in situations where the patient is incoherent or unable to make decisions, you are the doctors patient. It is just disheartening to know that some physicians do not have the time, or do not take the time to explain the treatments, procedures, and drugs that the patient may be given.
And the patient may not know to ask. Many patients may have never visited a physician or a hospital and thus may not know what to ask the physician. They may not understand the risks they are taking if they ingest a drug. They may not understand the risks of x-rays and IV’s and so they never think to ask. These issues may prevent the patient from having all his rights as a patient –knowing everything that will happen when it happens.
This is why it isn’t informed consent that should be changed, but the way in which information is relayed to he patient. Patients should be given multiple modes of communication. There should also be ways in which the information can be presented to patient in a way that eliminates all the medical jargon.
While I agree with your emphasis on the importance of informed consent, I think that you completely glossed over the underlying problem: that physicians do not have enough time to spend with their patients. In order to make small changes, larger changes must be made first, especially in regards to how the entire medical system operates in the United States. Doctors are paid by the number of patients they see, or procedures they do, so they have this incentive to see more patients. This means less time is spent with each patient. In order to have the time to thoroughly inform their patients, doctors must first have more time overall, instead of trying to crunch every minute detail into five minutes, which is not helpful for the patient.
I agree with you that patients should have options and be able to decide what the course of action should be. I don’t believe that it is up to doctors alone to completely inform patients about what will happen, patients also need to ask questions about what they don’t understand. Often, doctors do gloss over any pertinent information that patients should know. I believe that, while there is a lot of information on the web , people are able to find relevant information about any procedure being performed. They may have to sift through a bunch of junk, but if they look long enough, they will find useful information and they can take that info and talk to their doctor about it. Also, if doctors don’t have enough time to spend with all their patients, then how can we, as patients, expect our doctors to know enough about us to make the right choice for us?
I agree with you that the doctor-patient relationship gap has widened over the years and there is definitely a lack of communication between the two. Doctors would rather pay for an expensive software which would educate patients via videos, graphics, audio clips and scripts than to educated patients themselves. Check out this website: http://store.preop.com/. Many surgeons, these days, schedule an office visit for patients to come out and watch a video of the scheduled procedure as part of an education process. I really think though that we cannot blame either party for the changes in this relationship. It’s the overall changes in the health care industry that have placed extraordinary pressure on the doctor-patient relationship. The needed trust between doctors and patients has declined over the years because of lawsuits, poor medical and surgical practices, negligence, monitory gains etc. and the ethical foundation on which this relationship was built upon has been altered. As a result of a weak doctor-patient relationship, not only patients have to suffer with poor care, but even doctors are at a higher risk of being sued for medical malpractice. I think that medical treatment is a mutual process. Both parties have to understand that they both have a “gray zone” of decision-making and both have to consider the risks and benefits of the treatment. Looking at the number of lawsuits in medical industry because of sour doctor-patient relationship, I believe improving communication between the two is worth the effort.
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