Dr. Andy

Reflections on medicine and biology among other things

Thursday, March 24, 2005

"Informed" Consent

The Anonymous Clerk notes use of high pressure to obtain "informed" consent of electroconvulsive therapy for depression (which is actually safe and effective. They need to get the convulsive out of the title, maybe rename it, global electric stimulation therapy or something).

This reminds me of a time in residency when a patient needed the attending to obtain informed consent from a family for some study. The attending's response was

Sure, I'll obtain informed consent. But let me know which kind. If you want the "this is an innovatiive, exciting new therapy that could change the way we view this disease; if it were my child I'd definitely do it" I'll get that. On the other hand if you want "this is an experimental treatemnt whose safety is unknown. It seems kind of risky, given there are other, well-studied alternatives, but if you want to expose your child to that risk because it might be slightly better, that is your right" kind of consent, I can get that too.

Realistically, patients come to doctors because they are experts in the field. If they new about all the risks, benefits, alternatives, etc. they wouldn't need us.


At 2:19 PM, Blogger The Clerk said...

I think that's a great point - really where the heart of the informed consent issue lies.

At 5:42 PM, Anonymous Anonymous said...

I think the heart of the issue of informed consent lies with the fact that much in medicine has become biased due to the desires of the specialist and their interests. There is much that we do today that does little to measure quality of life after proceedures. The latest proceedures reimburse the best! I think the coment on which type of consent is most appropriate. Perhaps everyone should get both pitches.


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