Informed Consent in Hospital Practice: Health Professionals' Perspectives and Legal Reflections

Heywood, Rob; Macaskill, Ann; Williams, Kevin

doi:10.1093/medlaw/fwq008

Cited by 19 publications

(28 citation statements)

References 8 publications

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“…Heywood et al (2010) argue such legal concerns have tainted doctors’ perceptions of consent, encouraging them to give prominence to potential risks. Few participants in our study discussed explicitly the benefits of treatment, suggesting that it may not only be doctors but patients who also give prominence to the legal aspects of the consent process.…”

Section: Discussionmentioning

confidence: 99%

“…Few participants in our study discussed explicitly the benefits of treatment, suggesting that it may not only be doctors but patients who also give prominence to the legal aspects of the consent process. Arguably, focusing on risk may cause patients unnecessary angst and lack of appreciation of the benefits of the proposed treatment (Heywood et al, 2010). If the focus remains on risk, it has been argued that it is unlikely to improve communication between the patient and the doctor (Miola, 2009).…”

Section: Discussionmentioning

confidence: 99%

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The consent process: Enabling or disabling patients’ active participation?

et al. 2016

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Standards expected by doctors’ regulatory bodies in respect of the process of consent to treatment have arguably sought to restructure the nature of the doctor–patient relationship from one of the paternalism to that of shared decision-making. Yet, few studies have explored empirically, from patients’ perspectives, the extent to which the process of consent to treatment enables or disables patients’ participation in medical decision-making. Our article examines patients’ attitudes towards the consent process, exploring how and why these attitudes influence patients’ active participation in decision-making and considering possible consequent medico-legal issues. Data were collected longitudinally using semi-structured interviews and field observations involving 35 patients and 19 of their caregivers, in an English hospital between February and November 2014. These indicate that generally patients defer to the doctor in respect of treatment decision-making. Although most patients and their caregivers wanted detailed information and discussion, they did not necessarily expect that this would be provided. Furthermore, patients perceived that signing the consent form was an obligatory routine principally to protect doctors from legal action should something go wrong. Our study suggests that patients’ predominantly paternalistic perceptions of the consent process can not only undermine attempts by doctors to involve them in decision-making but, as patients are now considered in law as informed actors, their perceptions of the consent form as not being in their interests could be a self-fulfilling prophecy if signing is undertaken without due consideration to the content.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The consent process: Enabling or disabling patients’ active participation?

et al. 2016

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“…33,39 In addition to respecting patient preferences, other key principles associated with SDM are the importance of providing information to patients, which is timely, balanced and tailored specifically to their needs, the impact of family and cultural influences on medical decision making, and encouraging and empowering patients to be active members of their own healthcare team. 9,29,30,40 Bakitas et al 33 acknowledged that tailoring options may decrease the possibility of fully informed consent, but argued it will increase patients' abilities to participate in discussions and help build trusting relationships with HCPs. 27,30,39 Providing balanced and tailored information Practice guidelines 2 acknowledge that patients wish to be treated as individuals and personal preferences regarding their role in SDM can be varied and impacted by disease progression, cultural influences and input from others.…”

Section: Sdmmentioning

confidence: 99%

“…Disease experience is a unique characteristic of this patient population, which can impact SDM discussions because of an already increased familiarity with treatment regimens. 29,33 Patients want professional input to guide them through the SDM process, especially when faced with advanced disease. 26,[43][44][45] Access to this wealth of information allows patients to feel empowered, in control and more satisfied with health-related outcomes; however, it could also result in interpersonal issues between HCPs and the patient, hindering communication and SDM.…”

Section: Sdmmentioning

confidence: 99%

Shared decision making in palliative cancer care: a literature review

Feuz

2013

J Radiother Pract

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Background: Patients require information to make informed decisions and consent to medical treatment. Shared decision making (SDM) is a methodology that promotes a patient-centred approach to informed consent and demonstrates respect for autonomy Purpose: The purpose of this paper is to critically review the legal and ethical issues relevant to Canadian and UK informed consent and SDM practices and how these processes relate to current palliative care practices, with a particular emphasis on radiation therapy.Methodology: A review of the English literature from 2003 to 2013 was performed using the databases PubMed (NML), OVID Medline and Google Scholar. Results and Conclusions:The literature identifies that palliative cancer patients desire the opportunity to be involved with decision-making discussions, which has shown to increase knowledge and result in better health-related outcomes. However, ethical and legal issues regarding the practicality of including this patient population in SDM discussions raises questions about validity of consent. For SDM to be considered a valid methodology to obtain informed consent, open and honest communication between the patient and multidisciplinary team is essential. Treatment options for palliative cancer patients are often complex and SDM allows healthcare professionals and patients to exchange information and negotiate feasible treatment options based on medical expertise and patient preferences.Legal frameworks have defined current standards of practice for various healthcare professions, including radiation therapy. Radiation therapists, as members of the multidisciplinary team, are currently key contributors in providing information to patients regarding the radiotherapy process. Individuals working within advanced practice roles have the ability to develop skills once considered to be within medical domains and have begun to incorporate the delegated act of obtaining informed consent into practice which has shown to increase professional autonomy, accountability and improves patient-centred care.

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“…2,3 English law remains uncertain on these issues and it is left up to healthcare organizations to determine how to do it and how to record details of what information patients have been given and what they have consented to. 4 There is no clear requirement to check that the information has been absorbed and understood and there has been surprisingly little research into the practice of informed consent that might help to clarify these issues. Recent developments in the USA encouraging the use of certified high-quality patient decision aids when obtaining informed consent may provide a useful pointer on how to progress this issue in the UK.…”

mentioning

confidence: 99%

From informed consent to informed request: do we need a new gold standard?

et al. 2013

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It is generally accepted that valid consent must be obtained before providing invasive or risky treatment -indeed it is a legal and ethical requirementbut there is much debate about how best to do it in clinical practice. 1 In England, the Department of Health and the General Medical Council (GMC) have provided guidance on the general principles, but there is no consensus on how much information about treatment benefits and harms should be provided, how these should be communicated, or whether, when and how information about alternative treatments should be made available. 2,3 English law remains uncertain on these issues and it is left up to healthcare organizations to determine how to do it and how to record details of what information patients have been given and what they have consented to. 4 There is no clear requirement to check that the information has been absorbed and understood and there has been surprisingly little research into the practice of informed consent that might help to clarify these issues. Recent developments in the USA encouraging the use of certified high-quality patient decision aids when obtaining informed consent may provide a useful pointer on how to progress this issue in the UK.

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Informed Consent in Hospital Practice: Health Professionals' Perspectives and Legal Reflections

Cited by 19 publications

References 8 publications

The consent process: Enabling or disabling patients’ active participation?

The consent process: Enabling or disabling patients’ active participation?

Shared decision making in palliative cancer care: a literature review

From informed consent to informed request: do we need a new gold standard?

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