The probability that the proposed treatment will be successful
Review the following lecture:
Patient Consent
Discussion Questions
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Before the end of the week, begin commenting on at least two of your classmates’ responses. You can ask technical questions or respond generally to the overall experience. Be objective, clear, and concise. Always use constructive language, even in criticism, to work toward the goal of positive progress. Submit your responses in the Discussion Area.
Introduction:
Review the case and address the questions that follow:
The plaintiff, Bonita Perkins, in Perkins v. Lavin, was a Jehovah’s Witness. She gave birth to a baby at the defendant’s hospital. After going home, she began hemorrhaging and returned to the hospital. She specifically informed the defendant’s employees that she was not to be provided any blood or blood derivatives, and she signed a form to that effect:
I request that no blood or blood derivatives be administered to [plaintiff] during this hospitalization, notwithstanding that such treatment may be deemed necessary in the opinion of the attending physician or his assistants to preserve life or promote recovery. I release the attending physician, his assistants, the hospital, and its personnel from any responsibility for any untoward results due to my refusal to permit the use of blood or its derivatives.
Because of the plaintiff’s condition, it became necessary to perform an emergency dilation and curettage. She continued to bleed, and her condition deteriorated dramatically. Her blood count dropped, necessitating administration of blood products as a lifesaving measure. Her husband, who was not a Jehovah’s Witness, consented to a blood transfusion, which was administered. The plaintiff recovered and filed an action against the defendant for assault and battery. The plaintiff’s claim as to assault and battery was sustained.
The plaintiff specifically informed the defendant that she would consider a blood transfusion as offensive contact. Although both parties noted that the plaintiff’s husband provided his consent for the transfusion, the defendant had not argued that his consent was sufficient to overcome the plaintiff’s direction that she was not to receive a transfusion. The plaintiff submitted sufficient evidence to the trial court to establish that there was, at least, a genuine issue as to whether the defendant intentionally invaded her right to be free from offensive contact. Because of the plaintiff’s recognition that the defendant acted to save her life, a jury may find that she is entitled to only nominal damages.
Tasks:
Should the court be the ultimate decision maker when there is a dispute over whether a lifesaving measure should be administered to a nonconsenting patient? Explain.
Should a parent have the right to refuse a lifesaving treatment (e.g., transfusion) for a minor? Explain.
To support your work, use your course and textbook readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.
Your initial posting should be addressed at 300–500 words as noted in the attached PDF. Submit your document to this Discussion Area by the due date assigned. Be sure to cite your sources using APA format.
Patient consent is an important part of running healthcare organizations that are compliant with legal and ethical expectations. Consent may be defined as “. . . voluntary agreement by a person who possesses sufficient mental capacity to make an intelligent choice to allow something properly by another to be performed . . .” (Pozgar, 2016, p. 413). Generally, patient consent may come in two forms:
Expressed consent is communicated verbally or through written words—explicit permission.
Example: Yes, I consent to this procedure.
Implied consent involves the presumption that consent has been authorized—action relayed.
Example: Rolling up a sleeve to give blood for testing.
Consent must be informed that is, a patient has the legal right to understand the risks, benefits, and alternatives to any proposed procedure. This ensures that the patient is making a sound decision based on complete knowledge and evaluation of available options.
As a healthcare administrator, you may be asked to develop or maintain informed consent forms for your organization. An informed consent form should include the following elements:
The nature of the patient’s illness or injury
The name of the proposed procedure or treatment
The purpose of the proposed treatment
The risks and probable consequences of the proposed treatment
The probability that the proposed treatment will be successful
Any alternative methods of treatment along with their associated risks and benefits
The risks and prognosis if no treatment is rendered
An indication that the patient understands the nature of any proposed treatment, the alternatives, the risks involved, and the probable consequences of the proposed treatment
Signatures of the patient, physician, and witnesses
The date the informed consent form is signed
In some cases, however, consent must be statutory. In emergency scenarios, for example, where immediate intervention is necessary to prevent long-term impairment or death, consent is statutory. Additionally, parents or legal guardians may give consent on behalf of a minor child or for an individual who is deemed incompetent to give consent.
Case Study
Consent can be implied in nonemergency situations. For example, a patient may voluntarily submit to a procedure, implying consent, without any explicitly spoken or written expression of consent. In the Massachusetts case of O’Brien v. Cunard Steam Ship Co. (1891), a ship’s passenger who joined a line of people receiving injections was held to have implied his consent to a vaccination. The rationale for this decision is that individuals who observe a line of people and who notice that injections are being administered to those at the head of the line should expect that if they join and remain in the line they will receive an injection. The plaintiff entered the line voluntarily. The plaintiff had the opportunity to see what was taking place at the head of the line and could have exited the line but chose not to do so. The jury appropriately determined this to be consent to the injection. The O’Brien case contains all of the elements necessary to imply consent to a voluntary act: The procedure was a simple vaccination. The proceedings were visible at all times, and the plaintiff was free to withdraw up to the instant of the injection.
Reference:
O’Brien v. Cunard Steam Ship Co., 28 N.E. 266 (1891)
Additional Materials
From your course textbook, Legal and Ethical Issues for Health Professionals, review the following chapter:
Patient Consent
From the South University Online Library, review the following articles:
Transparency and Choice in Learning Healthcare Systems
Recording Advance Decisions to Refuse Treatment
Patient Preferences toward an Interactive E-Consent Application for Research Using Electronic Health Records
The Quality of Informed Consent after the Establishment of Patient Safety Standards: The Consent of the Physician, The Presence of a Third Party, The Description of the Type of Procedure, The Description of the Benefits of the Procedure
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