(1) Admission consent form. The admission consent form covers routine
hospital services, diagnostic procedures, and medical treatments. X-rays, lab work, and
day-to-day routine procedures would fall into this category.
(2) Special consent form. A special consent form is obtained before every
medical and surgical procedure or treatment that is not routine. For example, a CAT
scan requiring injection of a contrast media would require a special consent form. (See
next page for SF 522, "Request for Administration of Anesthetic or Performance of
Operation and Other Procedures.")
1-13. MODELS OF INFORMED CONSENT
a. Assent Without Understanding Not Informed Consent. Beginning in the
1950's the rules of consent began to change. The fact that a patient had consented to
treatment meant very little if, in fact, the patient had no idea as to what he or she was
being asked to deliberate. The courts started imposing an affirmative responsibility on
physicians to provide sufficient information in order for the patient to give an informed
consent. (See paragraph 1-2 to review the definition of informed consent.)
b. Institutional Model of Consent. There is a limited interpretation of informed
consent that does not entirely fulfill the higher ethical principle of patient self-rule. I n
this sense, the hospital simply fulfill the regulatory requirements for obtaining a legally
valid informed consent when relevant information is obtained. Thus, the physician (who
informs the patient of the risks of a proposed intervention) ascertains that the patient
has understood the risks, and then gets the patient to sign the proper authorization form
fulfilling the institutional requirements for informed consent. This model of consent is a
one-way communication process in which the physician transmits a body of information
to the patient.
c. Autonomy Model of Consent. The real intent of patient consent is to
support the patient's right to self-determination (autonomy). This means that the patient
has a decisive role to play in the medical decision-making. The patient does more than
just go along with a treatment plan. The patient actively authorizes the proposal in the
act of consent. This authorization is a culmination of an ongoing dialogue between
patient and physician aimed at discovering what is relevant to the patient and how to
apply it to the patient's unique circumstances. Treatment options are discussed and
consensus is reached on a treatment plan.
MD0067
1-14
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