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Lecture 5

HLT POL 100 Lecture 5: HLT POL Week 5 lect 1


Department
Health Policy and Management
Course Code
HLT POL 100
Professor
Marcy Boroff
Lecture
5

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HLT POL Week 5 lect 1
Welcome to the lecture on informed consent and mental competency. Informed consent is legally
required prior to any medical treatment. Informed consent evolved from the concept that society thinks
it is important for patients to understand their health status and treatment options prior to making
decisions about medical care.
It is important for patient advocates to fully understand the legal basis of informed consent since, as a
patient advocate, you may be involved in conversations with your client and their physician about their
health care and treatment options.
Patient advocates need to also understand the concepts of mental competency and mental incapacity
since the relationship with a client will change if their mental competency changes during the time they
are working together.
The process of informed consent involves much more than getting a patient to sign a written form. The
informed consent document should provide finality and formality to a full discussion about treatment
options. As a patient advocate, you have the opportunity to be very involved in making sure this process
is thorough and meaningful.
The Role of the Patient Advocate
The role of the Patient Advocate in the Informed Consent process includes:
Facilitating communication between the provider and patient
Overcoming barriers
Ensuring that the patient understands the treatment/procedure and has an opportunity to ask
questions
Many patients do not understand basic information about the risks and benefits of and
alternatives to their proposed treatment. There are a variety of reasons why patients do not
comprehend this including: low levels of literacy; low health literacy; limited English proficiency;
cognitive impairments; learning disabilities; hearing or vision impairments; confusion about the
purpose of the consent process; a feeling of intimidation; and stress or time pressure.
Patient advocates can help overcome some of these barriers to informed consent by identifying
why the patient does not comprehend and then providing the resources necessary to address
the issues. This may include arranging for an interpreter, explaining the procedure or options to
the patient or asking the provider to explain or providing additional resources as needed.
What is Informed Consent?
The American Medical Association defines informed consent as

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“a process of communication between a patient and physician that results in the
patient’s authorizations or agreement to undergo a specific medical intervention”
An opportunity for the patient to ask questions and discuss alternatives
It facilitates decision making
Requires that the patient has the ability (competency) to make an informed decisions
Informed consent is the process by which a fully informed patient can participate in choices
about his or her health care. It originates from the legal and ethical right a patient has to direct
what happens to his or her body and from the ethical duty of the physician to involve the
patient in his/her health care.
Informed consent is given based upon a clear appreciation and understanding of the facts,
implications, and future consequences of an action. In order to give informed consent, the
individual concerned must have adequate reasoning faculties and be in possession of all
relevant facts at the time consent is given.
In order for the patient's consent to be valid, he must be considered competent to make the
decision at hand and his consent must be voluntary. It is easy for coercive situations to arise in
medicine. Patients often feel powerless and vulnerable. To encourage voluntariness, the
physician can make clear to the patient that he is participating in a decision, not merely signing a
form. As a patient advocate, you can ensure that your client is making a voluntary decision.
Impairments to reasoning and judgment may make it impossible for someone to give informed
consent. Impairments maybe caused by basic intellectual or emotional immaturity, high levels of
stress, severe mental retardation, severe mental illness, severe sleep deprivation, dementia, or
being in a coma.
Later in this presentation, we will talk about mental capacity and mental competency and the
role of the patient advocate.
History of the Informed Consent Requirement
From battery to negligence
Requirements
sufficient information for a patient to make an informed decision
would another physician agree that is was sufficient information
Lets take a step back and look at the history of informed consent.
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