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4 - Consent and informed decision making

Kerry J. Breen ,
Stephen M. Cordner ,
Colin J. H. Thomson  and
Vernon D. Plueckhahn
Kerry J. Breen
Affiliation:
National Health and Medical Research Council
Stephen M. Cordner
Affiliation:
Monash University, Victoria
Colin J. H. Thomson
Affiliation:
University of Wollongong, New South Wales
Vernon D. Plueckhahn
Affiliation:
Monash University, Victoria
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Summary

There are ethical and legal reasons why doctors must adequately inform patients about proposed treatments or procedures, especially in regard to risks and dangers, and be satisfied that patients understand and consent to such measures. Ethically, this arises principally out of respect for the autonomy of the patient. The two-way information exchange required in order to bring patients to a position from which they can provide meaningful consent (an exchange referred to as ‘shared decision making’) is an essential component of good medical practice. Doctors who fail to adequately inform their patients about their condition, treatment options or material risks of treatment may be sued on the grounds of negligence (see Chapter 7). Exceptions to the requirement for consent are uncommon but include genuine emergencies and situations where treatment has been authorised by a court. In addition, if a doctor undertakes any procedure that involves touching the patient without consent, the doctor is guilty of an assault or, more precisely in legal terms, a battery, and an action in trespass may be brought against the doctor in a civil or a criminal court.

Just as there are both ethical and legal reasons for seeking informed consent, so too there are ethical and legal paths to understanding the principles involved in seeking informed consent. The legal pathway involves a detailed appreciation of what the courts in Australia and elsewhere have said about consent.

Type
Chapter
Information
Good Medical Practice
Professionalism, Ethics and Law
 , pp. 49 - 68
Publisher: Cambridge University Press
Print publication year: 2010

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References

Mulheron, R.Twelve tests to identify whether a medical risk is ‘material’. National Law Review 2000; 11: 1–19 (also accessible at http://www.pandora.nla.gov.au).Google Scholar
Rogers v Whitaker [1992] 109 ALR 625.
General Guidelines for Medical Practitioners on Providing Information to Patients and Communicating with Patients: Advice for Medical Practitioners. NHMRC, Canberra 2004. http://www.nhmrc.gov.au/publications/synopses/e57syn.htm and http://www.nhmrc.gov.au/publications/synopses/e58syn.htm
,Australian Medical Association. Position Statement on Informed Financial Consent. 2006. http://www.ama.com.au/web.nsf/doc/WOOD-6S987R
Making Decisions About Tests and Treatments: Principles for Better Communication Between Healthcare Consumers and Healthcare Providers. NHMRC, Canberra, 2005. http://www.nhmrc.gov.au/publications/synopses/hpr25syn.htm
Savelescu, J, Kerridge, IH.Competence and consent. Med J Aust 2001; 175: 313–15.Google Scholar
Appelbaum, PS.Clinical practice. Assessment of patients' competence to consent to treatment. NEJM 2007; 357: 1834–40.CrossRefGoogle ScholarPubMed
Grisso, T, Applebaum, PS.Assessing Competence to Consent to Treatment: A Guide for Physicians and Other Health Professionals. Oxford University Press, New York, 1998.Google Scholar
Gillick v West Norfolk AHA [1986] AC 112.
Secretary, Department of Health and Community Services v JWB and SMB (1992) FLC 92–293.
Skene, L.Law and Medical Practice. Rights, Duties, Claims and Defences 3rd edn. LexisNexis Butterworths, Sydney, 2008, p. 168.Google Scholar
Guardianship and Administration Board Act 1986 (Vic). http://www.dms.dpc.vic.gov.au/
,New South Wales Guardianship Tribunal. Substitute Consent. http://www.gt.nsw.gov.au/information/doc_14_substitute_consent.htm
Medical/Dental Treatment for Patients Who Cannot Consent: The Person Responsible. Office of the Public Advocate Victoria. http://www.publicadvocate.vic.gov.au/Medical-Consent.html
,Tasmania Guardianship and Administration Board. Consent to Medical and Dental Treatment. http://www.guardianship.tas.gov.au/consent_for_treatment
,New South Wales Health Department 2004. Using Advance Care Directives. http://www.health.nsw.gov.au/pubs/2004/adcaredirectives.html
,New South Wales Health Department 2005. End-of-Life Care and Decision-Making Guidelines. http://www.health.nsw.gov.au/policies/gl/2005/GL2005_057.html
Stewart, C, Kerridge, I, Parker, M. The Australian Medico-Legal Handbook. Churchill Livingstone Elsevier, 2008, pp. 121–3.Google Scholar
Clark, S, Oakley, J (eds). Informed Consent and Clinical Accountability. The Ethics of Report Cards on Surgeon Performance. Cambridge University Press, Melbourne, 2007.CrossRef

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