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CONSENT IN MEDICAL PRACTICE

CONSENT IN MEDICAL PRACTICE. The word CONSENT is both verb and noun. mean “agree or to say yes”. Provision of treatment is an implied contract between doctor and patient and the situation is governed under civil law. Conventional rule of conduct Any physical contact or application

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CONSENT IN MEDICAL PRACTICE

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  1. CONSENT IN MEDICAL PRACTICE The word CONSENT is both verb and noun mean “agree or to say yes”

  2. Provision of treatment is an implied contract between doctor and patient and the situation is governed under civil law

  3. Conventional rule of conduct • Any physical contact or application • of force without prior permission is • assault / battery

  4. Patient is not obliged to submit and • doctor can not impose treatment without • Permission / Consent • Note: Contagious / dangerous disease for others

  5. Permission does not absolve the doctor from his duty: • Care and skill • Professional secrecy • (Rule of law while in professional relationship) Note: Procedures during diagnosis / examination are considered as part of the medical treatment

  6. Legal Position: No specific law. Situation governed underContract act 1872: Sec 13. “Consent” Two or more persons said to consent when they agree upon same thing in the same sense

  7. Legal Position: • Sec 14. “Free consent” • Consent is said to be free when it is not • caused by: • Coercion • Un due influence • Fraud • Misrepresentation • Mistake

  8. Age of consent Age of majority

  9. Consent taking procedures (Standard Procedure) • Consent should be: • Full • Free • Without fear and • Fraud • From the patient or person in charge of • patient

  10. Consent taking procedures (Standard Procedure) • Having consideration of Age, Mental state, • any influence on patient ( physical / disease / • drug ) • Before the actual start of examination / • treatment • Extent of explanation

  11. Doctrine of informed consent Understandable communication between doctor seeking consent and the person entitled by law to grant consent Legal duty rest upon doctor to make the patient understand Doctor should inform the patient:

  12. Doctrine of informed consent Diagnosis—marginal discretion Choice of treatment Doctor’s experience in rendering the treatment Methods which will be used Major and collateral risk involved Hospital stay (if any) with attendant pain or discomfort

  13. Alternate to the proposed treatment • Prognosis • Probable results of the foregoing treatment • 10. In case of new or un-orthodox procedure a great duty of disclosure exists and the doctor must make this exceptionally clear to the patient. If the patient makes inquiry of any pertinent matter, doctor should readily respond with a specific and detailed answer Doctrine of informed consent

  14. Types of consent: According to situation / circumstances i.e. emergency or otherwise • Implied • Expressed Oral / Written • Blanket Note: All are valid in the eyes of law but for evidential purpose, Expressed Written is necessary

  15. CONSENT FORM I, (name of the consentee) NIC number (of the consentee) do hereby consent to (my own / relationship with the patient) operation of (name of operation) under (type of anesthesia) anesthesia. I have been explained fully the nature, purpose and inherent risks involved in this surgery and the type of anesthesia by Dr (name of the doctor taking consent) No assurance has been given to me that any particular surgeon will perform the operation Signature of the consentee Date I confirm that all relevant detail in respect of the above referred operation and anesthesia have been fully explained to the consentee who has signed this form Signature of the doctor taking consent Date

  16. Situations / modifying factors (modified Procedure) Infant / Minors / Religious faith Christians Jehovah’s Witness Muslims Alcohol, Morphine

  17. Situations / modifying factors (modified Procedure) Unconscious patient Patient’s health interests are superior to legal formalities

  18. Situations / modifying factors (modified Procedure) • Married patients • (Especially when treatment involves organs of generation) • Provision of oral contraceptives to treat • menstrual irregularity, avoid pregnancy • IUDC to save mother’s life, avoid pregnancy • Surgical sterilization of minors, majors • Artificial insemination i.e. AIH / AID

  19. Situations / modifying factors (modified Procedure) • Lunatic / Mental patient • Lunacy Act 1912 and modification there under • Mental Health Ordinance 2001

  20. Situations / modifying factors (modified Procedure) Consent in real emergency Exception to the doctrine of informed consent

  21. Situations / modifying factors (modified Procedure) Consent in organ transplantation In no case the organs be removed from un-accompanied body

  22. Consent in medico legal cases Dead:State / Next of Kin Live:Oral or Expressed Written consent + Third party Implied consent cannot be assumed

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