informed consent information

[ltm]

This is just a message searching for some basic info on informed consent. I just need to know the laws on informed consent and when a nurse can be obligated to intervene. My understanding is that if you suspect that your patient has not received proper informed consent, that you must alert the physician and share that with him. Well what happens when you have shared it with the physician and he just wants to go on with the procedure without dealing with the problem of inadequate informed consent??? I cannot seem to find any research on the topic. Any experience, knowledge, or advice would be greatly appreciated.

Thanks,

ltm

[MollyJ]

I think Informed Consent is just a hard obligation to meet at times. It is a meeting point of the doctor's communications skills, the patient's intellect, their ability to receive information [related to their anxiety and stress, for example] and probably some other issues.

I think this is a "keep it simple" issue. If the doctor goes in and does his spiel and the client, after he leaves, says something like, "You mean, they're actually going to make a cut in my abdomen?", then you go out to the doctor and say, "The patient has more questions." And you report their question. Many doctors will be exasperated, but most will understand that their is information that they need to clarify.

I once did a vaccination clinic for influenza vaccine at a sheltered workshop for retarded adults. A surprising number of very local functioning adults still had the legal right to sign for themselves. This was very upsetting to me because it was hard to screen for allergies and hard to determine if they understood the service. Probably they most certainly did not. In actual practice, did most of these clients have "informed consent"? What would it have taken for them to have it? Was it attainable in some of these cases? [No.] I relayed all of my concerns to my employers about this situation. It wasn't perfect, but they are an at-risk population. The problem in this and many situations is that someone didn't care enough to seek power of attorney for these people at the age of 18 and likewise for many old people, who function well enough in their day to day world but are boggled by medical discussions.

The fact is that informed consent is not an present/not present situation. It is very complicated.