1. Introduction
1.1. What?
1.1.1. Taking permission from the patient
1.1.1.1. - Informing the patient of the options
1.1.1.2. - Giving him sufficient information to decide
1.1.1.3. - Only by the attending physician
1.2. Why?
1.2.1. Autonomy
1.2.1.1. - Deciding what to be done to your body
1.2.1.2. - Basic human right
1.2.1.3. - Your decision, no matter how ridiculous!
1.3. When?
1.3.1. Every time you touch a patient!
1.3.2. Types of consent
1.3.2.1. Implied
1.3.2.2. Express
1.3.2.2.1. Oral
1.3.2.2.2. written
2. Exceptions
2.1. No consent
2.1.1. Emergency
2.1.1.1. - Life threatening situation
2.1.1.2. - Possible serious health impairment
2.1.1.3. - Impossible to obtain the patient's consent
2.1.1.4. - It's presumed that treatment is wanted.
2.1.1.5. - Unless there are directions in advance
2.1.2. Extension Doctrine
2.1.2.1. - Unexpected additional care
2.1.2.2. - Not convent to take a new consent
2.1.2.3. - Preceding consent is extended
2.1.2.4. Unless:
2.1.2.5. It may affect reproduction
2.1.2.6. Patient previously refused care
2.2. Consent from others
2.2.1. minors
2.2.1.1. - Under 15 years old (Hijri)
2.2.1.2. - The guardian or custodian decides
2.2.1.3. - Must act in the best interest of the minor
2.2.1.4. - Minor's wishes have to be considered
2.2.1.5. - Court may take over the guardianship
2.2.2. incompetence
2.2.2.1. - Inability to make in informed decision
2.2.2.2. - Inability to comprehend the risks and benefits
2.2.2.3. - Communication issues are NOT under this criteria.
2.2.2.4. - Guardian required (substituted consent)
2.2.2.5. - Sometimes court order also required
2.2.2.6. Case study (true or false)
2.2.3. court order
2.2.3.1. - Example of a single dad refusing treatment
3. Components of Informed Consent
3.1. competency
3.1.1. - Ability to understand and explain the options
3.1.2. - Ability to give reasons to choose an option instead of the other
3.2. autonomy
3.2.1. - The right to refuse, regardless of the reason
3.2.2. Religion, skepticism, other..
3.3. understanding
3.3.1. explanation
3.3.1.1. Introduction
3.3.1.1.1. - Introducing yourself
3.3.1.1.2. - Diagnosis
3.3.1.1.3. - Name of the advised treatment
3.3.1.2. Explaining
3.3.1.2.1. - Nature and purpose of the treatment
3.3.1.3. Benefits and risks of treatment
3.3.1.4. Alternatives
3.3.1.4.1. - Other options for treatment
3.3.1.4.2. - May include their risks and benefits too
3.3.1.5. consequences of refusing the treatment
3.3.1.5.1. - The right to refuse treatment
3.3.1.5.2. - Consequences of that right (serious injury, death)
3.3.1.5.3. - May have to sign AMA form (against medical advice)