Consent! Is It so vital?

 

Dr Madhav Madhusudan Singh

MBBS, MHA (AIIMS) , MBA (Finance), Ph.D. ( Hosp Mx)

Introduction:

Consent is the most basic yet critical aspect of any medical procedure or treatment. It is the agreement by the patient to undergo the treatment or procedure after understanding its risks and benefits. Consent is a legal and ethical requirement and is essential to respect the patient's autonomy and rights. The importance of informed consent has been widely recognized worldwide, and it has become a legal requirement for healthcare professionals to obtain it before any medical intervention.

Why is consent required?

Consent is required for various reasons. Firstly, it is essential to respect the patient's autonomy and rights. Patients have the right to make decisions regarding their health, and it is the responsibility of healthcare professionals to provide them with the necessary information to make informed decisions. Secondly, informed consent ensures that patients are aware of the risks and benefits of a procedure or treatment. It helps them understand the potential outcomes and make an informed decision. Lastly, obtaining consent protects healthcare professionals from legal liabilities. Informed consent provides a legal shield to healthcare professionals against any potential malpractice claims.

Significance of Consent:

Informed consent is vital for patient safety and satisfaction. It enables patients to make informed decisions about their treatment options and helps them understand the potential risks and benefits. It also ensures that patients receive the best possible care and treatment, as healthcare professionals have to provide accurate and detailed information to obtain consent. Additionally, informed consent promotes transparency and trust between the patient and healthcare professional.

Challenges in hospitals & with doctors:

Despite its importance, obtaining informed consent can be challenging for healthcare professionals. One of the significant challenges faced by healthcare professionals is time constraints. In many cases, healthcare professionals have limited time to explain the treatment or procedure to the patient and obtain their consent. Another challenge is language barriers, especially in multi-lingual countries like India. Healthcare professionals may not be able to explain the procedure or treatment adequately in a language that the patient understands.

In India, the lack of awareness among patients about their rights and the importance of informed consent is a significant challenge. Patients often blindly trust their healthcare providers, and healthcare professionals may exploit this trust to obtain consent. Additionally, patients from lower socio-economic backgrounds may not be aware of their rights and may not have the necessary resources to seek legal recourse in case of any malpractice.

Relevant case file in India:

One of the most significant cases related to informed consent in India is the Supreme Court's judgment in Samira Kohli vs. Dr. Prabha Manchanda. In this case, the patient, Samira Kohli, underwent a sterilization procedure without being informed about the risks and potential complications. She suffered from severe complications after the procedure and filed a case against the doctor. The Supreme Court held that obtaining informed consent was a legal requirement and that the doctor had failed to provide adequate information to the patient before the procedure.

1.  Samira Kohli v. Dr. Prabha Manchanda & Anr. (2008): In this case, the Supreme Court held that informed consent is necessary before any medical treatment, and failure to obtain informed consent can result in medical negligence.

2.     Kusum Sharma & Ors. v. Batra Hospital & Medical Research Centre & Ors. (2010): The Supreme Court stated that it is the duty of the doctor to inform the patient about the nature of the treatment and risks involved. The doctor must take reasonable care to ensure that the patient understands the information provided.

3.     Martin F. D'Souza v. Mohd. Ishfaq (2009): The Supreme Court emphasized that informed consent is an integral part of medical ethics and that doctors must obtain the consent of patients before performing any medical treatment.

4. Malay Kumar Ganguly v. Dr. Sukumar Mukherjee & Ors. (2009): The Supreme Court ruled that the consent of the patient or the patient's family members must be obtained before administering any medical treatment, and failure to obtain consent can be considered medical negligence.

5.    S.P. Gupta v. President of India & Ors. (1982): The Supreme Court held that the right to informed consent is a fundamental right, and it is the duty of the doctor to ensure that the patient understands the nature of the treatment and the risks involved.

6. Anuradha Saha & Anr. v. Dr. Sukumar Mukherjee & Ors. (2013): The Supreme Court stated that doctors have a duty to provide information about the nature of the treatment, the risks involved, and the alternatives available, and that failure to provide this information can be considered medical negligence.

7.     Dr. Laxman Balkrishna Joshi v. Dr. Trimbak Bapu Godbole & Anr (1969): The Supreme Court held that informed consent is necessary for any medical procedure, and that doctors have a duty to explain the risks and benefits of the procedure to the patient.

8.     Dr. Suresh Gupta & Ors v. Govt. of NCT of Delhi & Ors (2004): The Delhi High Court held that doctors must take informed consent before conducting a medical procedure, and that the patient must be informed of the risks and benefits of the procedure.

9.     Achutrao Haribhau Khodwa v. State of Maharashtra & Anr (1996): The Supreme Court held that doctors have a duty to obtain informed consent before conducting a medical procedure, and that the patient must be informed of the risks and benefits of the procedure.

10.Dr. Mukhtiar Chand & Ors v. State of Punjab & Ors (1998): The Supreme Court held that consent must be taken for any medical procedure, and that the patient must be informed of the risks and benefits of the procedure.

 

How to improve consent taking in hospitals:

There are various ways to improve the process of obtaining informed consent in hospitals. Firstly, healthcare professionals should be trained to communicate effectively with patients. They should be able to explain the procedure or treatment in simple language and use visual aids to improve understanding. Additionally, healthcare professionals should take the time to answer the patient's questions and address any concerns they may have.

Secondly, hospitals should have clear guidelines and protocols for obtaining informed consent. These guidelines should be easily accessible to healthcare professionals, and they should be trained to follow them strictly. Hospitals should also conduct regular audits to ensure that healthcare professionals are complying with the guidelines.

Thirdly, hospitals should make use of technology to improve the process of obtaining informed consent. Electronic consent forms can be used to ensure that patients are provided with all the necessary information before consenting to the treatment or procedure. Additionally, electronic forms can be used to record the consent, which can serve as evidence in case of any legal dispute.

Conclusion

Informed consent is a crucial aspect of healthcare that ensures patient autonomy, safety, and satisfaction. Obtaining consent helps patients make informed decisions about their treatment options and protects healthcare professionals from potential legal liabilities. However, there are challenges in obtaining informed consent, including time constraints, language barriers, and a lack of awareness among patients. To improve the process of obtaining consent, healthcare professionals should be trained to communicate effectively with patients, hospitals should have clear guidelines and protocols, and technology should be utilized. In conclusion, obtaining informed consent is vital for ethical and legal reasons and should be a priority in healthcare.

Dr Madhav Madhusudan Singh MBBS, MHA , MBA , Ph.D

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Disclaimer: The views expressed in this text are solely the personal opinions of the author and do not represent the views of any organization or entity with which the author may be affiliated.

 

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