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Physician's Guide to Medicine - Informed Consent
What is informed consent?
When is informed consent required?
What are the general requirements for informed consent?
Should informed consent be written?
Who may give consent?
What is implied consent?
What is informed consent?
Generally, informed consent is where the physician informs
the patient of the patientīs medical condition, the proposed treatment,
treatment alternatives, the treatment risks, and the likelihood of success.
When is informed consent required?
Informed consent is required prior to any and all treatment
rendered by a physician. If informed consent is not obtained prior to treatment,
and the treatment is unsuccessful with detrimental effects, the physician may be
held liable for malpractice.
Missouri law specifically requires informed consent for the following:
(1) Abortion - Every pregnant woman must sign a consent form, supplied by the
State Department of Health, acknowledging she has been informed and that her
consent is freely given.
(2) Experimental research - No patient of a mental health facility may be the
subject of experimental research without his or her prior written consent, or
that of his or her guardian.
(3) HIV testing - HIV testing must be performed with consultation and the
subjectīs consent, except that testing can be performed without the right of
refusal for inmates in state correctional institutions, sexual offenders,
certain mental health patients, or upon a court order.
What are the general requirements for informed consent?
Generally, the patient must be given sufficient
information to make an informed decision as to whether or not to undergo a
medical procedure. If the physician treats the patient without receiving the
patientīs consent, or if the physician does something which the patient does not
consent to, the physician may be liable for battery due to the lack of informed
consent.
Should informed consent be written?
A written form may be part of the informed consent
procedure, and is beneficial, but a written form by itself typically is not
sufficient. Instead, it is important the patient be given an opportunity to ask
questions and that all risks, benefits, etc., be explained to the patient, and
the conversation be documented in the patientīs record.
Who may give consent?
(1) Any adult eighteen years of age or older may consent for
himself or herself;
(2) Any parent, step-parent, or adoptive parent (including minors) may consent
for a minor child in his or her custody;
(3) Any minor who is or has been lawfully married may consent for himself or
herself;
(4) Any minor may consent for any child in his or her legal custody;
(5) Any minor may consent for himself or herself in the case of:
Pregnancy (excluding abortion);
Sexually transmitted diseases; or
Drug or substance abuse;
(6) Any adult standing in loco parentis may consent for a minor in an emergency;
(7) Any legal guardian may consent for a person in his or her ward; or
(8) Any adult, in the absence of a parent, may consent for his or her brother or
sister.
A physician acting in good faith, and who has not been put on notice to the
contrary, is justified in relying on a personīs representation as to identity,
age, marital status, and relationship to any other person for the purpose of
consent.
What is implied consent?
Under Missouri law, consent to surgical or medical
treatment or procedures is implied in an emergency, where the treatment or
procedures are immediately necessary to preserve the life, health, or limb of
the patient, and where a delay to obtain consent would result in impairment.
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