A SEDATED PATIENT CAN'T GIVE INFORMED CONSENT
Does the patient understand what the physician is saying? If after providing
adequate disclosure, a physician has reason to believe that the patient has passively
assented, merely gone along without understanding what he or she has been told,
then there has been no legally effective consent. And in such a case the physician
may be liable for battery. The obvious case is one in which the patient has been
given a sedative which keeps him or her from understanding some aspect of the
treatment. Consent obtained after sedation is probably not legally valid. A good,
prudent physician will determine whether the patient "understands" what's been said.
c. Consent, Voluntary and Authorized. A patient's permission is not legally
effective unless it is freely given without: duress, undue influence, or coercion.
Authorization should be clearly communicated (preferably in writing).
(1) Health care providers. The knowledge and authority of the health
care provider tends to foster a "doctor (health care provider) knows best" attitude that
can unduly sway the patient. Remember that consent, in its most desirable form, is
not merely assent with understanding. It is an active participation in the decision-
making process, a give-and-take regarding the pros and cons to arrive at the most
suitable treatment option.
(2) Family. Relatives who generally have the best interest of the patient
at heart may, in some instances, try to talk the patient into having a procedure that
is not really needed.
(3) Hospital environment. As stated earlier, a hospital is an inherently
stressful environment for a patient. It is a strange place where a lot of unfamiliar
things occur, many of which are painful. The ethical basis of legally valid consent is
the individual's right to autonomy (self-rule or self-determination). Yet, the hospital is
a place in which patients tend to give up the real-life autonomy they normally
exercise, because something is wrong with them, and they don't really know what to
expect.
MD0067
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