SERVICE MEMBER'S CONSENT NOT REQUIRED TO:
Preserve the life of a service member.
Alleviate undue suffering.
Maintain the health of others.
Isolate and quarantine.
Enforce detention on closed wards for the protection of the service member or
Provide medical care related to mental disorders.
Provide diagnostic medical care, physical exams, and associated procedures.
Figure 1-5. A service member's right to give consent is restricted. Anything
done to maintain or restore the service member's
deployability worldwide does not require consent.
1-10. CONSENT NO DEFENSE AGAINST NEGLIGENCE
Some physicians, nurses, and hospital administrators mistakenly assume that
written consent constitutes a valuable defense against charges of professional
negligence or malpractice. Written consent is, in fact, only valuable as evidence that
the patient gave consent for the procedure. It is of no value against charges that the
procedure was unnecessary or that the operator was guilty of professional negligence.
And, it is of little value if the patient can prove that he or she could not reasonably have
been expected to understand that for which he or she was asked to give consent. In
other words, consent is not a patient waiver of the right to sue for negligence. It is only
evidence that a procedure or treatment plan has been discussed.
1-11. ELEMENTS OF INFORMED CONSENT
a. Competence (Decision-Making Capacity). In order to obtain both an
express (oral/written) and an informed (knowledgeable) consent, the patient must have
certain characteristics, and must have made the decision under the right conditions.
First, the patient must be competent to make decisions. This means being of legal age
or emancipated (the parent has given up legal duties toward the child, e.g., the child has
left home and is self-supporting). To make valid decisions, the patient must be able to
take in and process information, that is, to reason. He or she must be able to
communicate, not necessarily to speak, but at least to make wishes known, e.g., by
blinking, nodding, and so forth. Also, the patient must be able to understand the
consequences of his or her decisions.
b. Information Disclosed and Understood. The cornerstone of informed
consent is providing the right information and making sure it has been understood. Not
only must the physician provide the relevant information, but also there is an affirmative
responsibility to ensure that the patient understands the information.