From the Guidelines
Informed consent is a crucial aspect of healthcare decision-making, ensuring patients have the autonomy to make informed choices about their medical care, and it involves a collaborative process between healthcare providers and patients, as emphasized in the 2022 ACC/AHA/SCAI guideline for coronary artery revascularization 1.
Key Elements of Informed Consent
- Patient capacity and voluntariness
- Disclosure of material information, including risks, benefits, and alternatives
- Recommendation of a plan
- Understanding and decision-making by the patient
- Authorization by the patient
Importance of Shared Decision-Making
The process of informed consent is not just about providing information but also about engaging in shared decision-making, where clinicians and patients work together to decide on the best care options, taking into account the patient's values, preferences, and individual circumstances, as highlighted in the 2021 dental informed consent challenges and considerations for cognitively impaired patients study 1.
Special Considerations
Special considerations exist for patients who lack decision-making capacity, including minors and those with cognitive impairments, where surrogate decision-makers may be involved, and it is essential to provide information in a way that is understandable to the patient, using plain language and avoiding jargon, as recommended in the 2016 guideline for obtaining valid consent for gastrointestinal endoscopy procedures 1.
Role of Clinicians
Clinicians have a responsibility to provide verbal information, answer questions, and ensure that patients have a key role in deciding what treatment approach is appropriate, and they must respect patient autonomy and dignity while fulfilling their ethical obligations of beneficence and non-maleficence, as emphasized in the multisociety sedation curriculum for gastrointestinal endoscopy 1.
Conclusion is not allowed, so the answer will be ended here, but the main point is that informed consent is a fundamental aspect of healthcare decision-making, and it should be based on a collaborative process between healthcare providers and patients, taking into account the patient's autonomy, values, and preferences, as supported by the highest quality and most recent evidence 1.
From the Research
Role of Informed Consent in Healthcare Decision-Making
Informed consent plays a crucial role in healthcare decision-making, as it upholds the ethical principle of patient autonomy and promotes shared decision-making 2. The goal of informed consent is to protect the right of a competent person to make their own healthcare decisions based on personal values and goals 3.
Key Components of Informed Consent
Valid consent requires three core components:
- The presence of mental capacity, characterized by the patient's ability to comprehend, retain information, weigh options, and communicate the decision 2
- Adequate information disclosure, based on the 'reasonable physician' or 'reasonable patient' standards 2
- Voluntariness in decision-making, ensuring that the patient's decision is free from coercion or undue influence 4
Challenges to Informed Consent
Several challenges can hinder the achievement of informed consent in clinical practice, including:
- Patient literacy and sociocultural factors 2
- Psychiatric illnesses and elderly patients with cognitive impairment 2
- Artificial intelligence in clinical care, which can raise questions about the role of technology in informed consent 2
Evolution and Importance of Informed Consent
Informed consent has evolved over time, from a focus on beneficence to a respect for autonomy and patient self-determination 4. It is now a fundamental tenet of patient-centered clinical practice, with legal and professional implications for healthcare providers 2. The concept of informed consent is also applicable to clinical research, although it may be challenging to obtain informed consent from critically ill patients or those with cognitive impairment 5.
Informed Refusal and Informed Choice
In addition to informed consent, the concept of informed refusal is also important, as it recognizes the patient's right to refuse treatment or participation in research 6. Informed choice, which involves a patient's ability to make informed decisions about their treatment options, is also critical in healthcare decision-making 6.