UK law clearly gives competent patients the right to refuse treatment (the few exceptions have been described in the chapter on legal frameworks). On the other hand, no patient has the right to request certain treatments. The GMC Regulation (2008) states that if a patient wishes a treatment that the physician believes is not clinically indicated, there is no ethical or legal obligation to perform such treatment.21 A pre-printed form containing information about the risks and benefits of certain medical treatments and procedures can help facilitate proper documentation of the informed consent process. But form alone is not enough. Joint Hospital Board standards require that a completed consent document be included in the medical record prior to surgery. A duly executed consent document is defined as a document structured to contain[ ] I therefore submit that the principle of total autonomy is philosophically contradictory when applied to society. Since autonomy is the most important ethical principle for informed consent, there can be no absolute right to consent. A patient must be given the opportunity to ask questions and clarify any doubts. There should be no pressure. Consent must be voluntary and the patient must have the freedom to withdraw consent. If consent is given out of fear of intimidation, or if it contains misconceptions or misrepresentations, it may be considered invalid. This e-learning module will help physicians determine the standard consent process and deal with situations where patients cannot give informed consent. Informed consent to medical treatment is fundamental in both ethics and law.
Patients have the right to receive information and ask questions about recommended treatments so they can make informed decisions about care. Successful communication in the patient-physician relationship fosters trust and supports joint decision-making. The four main principles of medical ethics are justice, non-malevolence, autonomy, and charity.8 Autonomy is the most important ethical consideration underlying informed consent. The right of patients to determine what tests and treatments they undergo must be respected by all physicians.3 Patients rely on their physician`s information to consent to information. Honesty and truthfulness are necessary to validate the consent process.3 The ethical principle of justice must be applied when deciding what treatments to offer or deny to patients. This touches on the informed consent process and is further investigated when the right to request certain treatments is discussed. Several restrictions on the right to consent are set by the legal framework in the United Kingdom (or England). The main government instruments concerned are the Mental Health Act, the Mental Capacity Act and the Public Health Act. UK law regulates the right of consent for minors, the mentally ill, patients unable to work and patients with communicable diseases. Your consent rights are limited and will not be granted in special circumstances.
Disclosure of information without consent is mandatory in infectious disease cases and legal in cases where the physician believes the non-disclosure puts the public at risk. In addition, patients can be recruited for emergency medical studies without consent under strict EU regulations. There is therefore no absolute right to consent on a legal basis. „Informed consent“ is the process by which a patient knows and understands the purpose, benefits and potential risks of medical procedures, including clinical research trials, and then agrees to receive the treatment or participate in the study. It could be said that informed consent derives both from the ethical principle of fundamental human rights and from a legal point of view. Some may question whether informed consent is necessary, perhaps pointing out that maintaining a good doctor-patient relationship often works better than more informed consent. Is it really worth the paper it is written on if its validity can only be clarified in court? Does „informed consent“ result from legality or ethics? If it is outlawed, it means that ethics does not matter. On the other hand, even if it`s legal, it could still become unethical! The debate on whether a right or principle is absolute is not only about ethical and legal aspects. It also touches on the philosophical argument of the absolute.
Freedom as an example cannot exist as an absolute principle, because the granting of absolute freedom to one individual seriously violates the freedom of a second individual. Person A`s freedom to withdraw all goodwill affects Person B`s freedom to own property. When these principles are applied to autonomy, the same problem arises: the total autonomy of one individual negatively affects the autonomy of other individuals. Modern democratic society has designed rules and laws to create an equitable way of life. On the one hand, this limits autonomy, while on the other hand, the same limited autonomy guarantees all members of that society the same degree of autonomy. The court then investigated the policy behind the consideration of Moore`s cell ownership. Since the exchange of goods constitutes strict liability, the court was concerned that the extension of property rights to tissues or organs would have a chilling effect on medical research. Laboratories that conduct research receive a large amount of medical samples and cannot be expected to know or discover if their samples were obtained illegally anywhere on the line. Moore could only sue his doctor for not leaking information and no one else. Patients have not only the right, but also the responsibility to participate in their care.
Discussions about research activities, therapeutic modalities and invasive procedures are an essential part of the treatment plan and should take place between the patient and provider as often as necessary to obtain effective informed consent. Joint decision-making is a principle first discussed in 1982 and based on the concepts of patient-centred care.3 The informed consent model is an element of the In addition, the Act established the concept of a continuing power of attorney (APA). This allows the patient to grant consent and refusal rights to an AHR while remaining capable. The APL then takes back these powers if the patient loses capacity. Currently, there is no legal right to request treatment in the UK. In addition, such requests violate justice by prohibiting the allocation of resources on an as-needed basis. The fundamental difference between consent and informed consent lies in the patients` knowledge behind the informed consent decision. Informed consent requires the patient to understand the diagnosis and uncertainties, as well as the different treatment options (including inaction) and their pros and cons and achievable outcomes.3 The amount of information required to inform consent may vary depending on the complexity and risks of the treatment and the patient`s wishes.3 In addition, Individual patients have different intellectual abilities and understanding of their disease. It is therefore imperative to adapt the information provided to each patient and to the current situation. An emergency such as an acute myocardial infarction, for example, leaves less time to discuss diagnosis and treatment than elective endoscopy.
How can we know for sure if consent is valid? As with any contract, no matter how carefully it is drafted, the only sure way to know if a contract will hold is if it is validated by a court. A medical procedure without valid consent is a criminal offense and the doctor can be charged with battery. Examples of such situations include treatment against the patient`s will, treatment other than that approved, and treatment after conscious consent with false information.9 Although the above regulations are clearly established by law, a physician may encounter situations where no clear instruction is given. If a patient confesses to a crime or planned crime to a physician, it is up to the patient to decide whether or not to share that information with the police. This decision requires careful consideration of whether the right to consent to the disclosure of information is more important than the public`s right to protection. The GMC guidelines (Confidentiality: Protecting and Providing Information, 2004) provide general guidance on disclosure, but leave the final decision to the physician.18 A review of the practicalities of consent shows that the information provided is often misunderstood and retained. Patients who give consent do so without being really informed. In other words, they cannot give informed consent because of their lack of understanding. As the practical aspects chapter shows, this is often not noticed by the attending physician or researcher. It is difficult to imagine an absolute right to consent in practice when efforts to provide the information necessary for informed consent so often fail. In order to protect the public form of infectious diseases, the Public Health (Disease Control) Act (1984) regulates disease reporting and compulsory treatment of diseases such as tuberculosis (TB).16 The individual`s right of consent is severely restricted in two areas: First, information about the patient`s diagnosis must be communicated to the competent authorities. The patient should be informed of this step.
Section 11 governs the disclosure of information. It is imperative that a doctor provides the patient`s personal data and diagnosis to the competent authorities, even if the patient does not agree. The list of notifiable diseases ranges from food poisoning to viral hepatitis and tuberculosis.
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