Obtaining a proper informed consent may be one of the best ways to protect oneself from undue litigation. In a study published in JAMA Dermatology1, approximately one-third of lawsuits stemming from injury sustained following laser surgery cited a failure to obtain a proper informed consent. All patients have the right to an informed consent. Informed consent is when a medical provider provides information to a patient in order for the patient to make a voluntary decision regarding the treatment. In general, the informed consent process must contain adequate information and should include discussion of the following:
1. The diagnosis and steps proceeding diagnosis (if applicable)
2. The nature and purpose of the treatment (i.e. benefits of treatment)
3. Risks of the procedure
4. Alternatives to the procedure
5. Assessment of patient understanding (e.g. signature)
It is important to keep the document simple, avoiding medical jargon and instead using layman terms understandable to a patient (e.g. use bruising instead of purpura; darkening of the skin instead of hyperpigmentation, etc). Comprehension is as paramount as the information being relayed. Attention must be paid to particular susceptibilities of the patient (e.g. hyperpigmentation more likely in darker skin phototypes). The process must also be specific to the particular procedure being performed. Broad, overreaching consents are not only ineffective in conveying the necessary information regarding the specifics of the procedure, but are also disfavored by the court system.
Patients who lack the capacity to make a medical decision cannot participate in the informed consent process. These include minors, for which parents must consent to the procedure, as well as those with a surrogate decision maker. Exceptions to full informed consents occur including life-threatening emergencies where the patient is not conscious. Conversely, performing a procedure that a competent patient is unaware of is considered battery.
Just as the provider has the duty to disclose accurate information to the patient, the patient too has the same duty. For example, if a patient is dishonest regarding their medical history and suffers a bad outcome, this can be a defense to an informed consent action.