We talk a lot about informed consent in health care. We have all signed multiple forms indicating we have heard and understood what is going to be done to/for us. Most of us never really read them.
They remind me of the software licenses we all see and “agree” to when we update programs or install new ones on our computers or game systems; who knows what might be buried in there?
Once, I had a nurse bring me a large pile of orders and labs to sign off, and I dutifully did so, not really paying as much attention as I should have. She loves to still tell the story of how she got me to sign a criminal confession that way! (She liked to write mysteries, and I think she was trying to see if this was possible, to include in a future story).
Words mean something. Is it really informed consent we want to get from our patients, or should we be trying to get their informed choice? It seems to me that consent is agreeing to a predetermined course. It says very little about the process of determining that course, though it does give lip service to alternatives, risks, and benefits. Informed choice, on the other hand, seems to me more in line with the concept of shared decision-making.
I would not suggest that we ignore what we know, but as health care providers, we certainly can do a better job of telling patients what the full range of options are, and the pros and cons of each.
Last Updated: November 6, 2018