what is informed consent controlled by?
state law, although there are general principles that should be considered regardless of the state
what is the difference between consent vs. informed consent
while it may be a simple mater just to get someone’s consent to care, it is informing the patient for their options so that they can make an informed treatment choice that becomes the key element
what are the four elements of informed consent?
- professional disclosure
- to the proper person
- at a time in a reasonable proximity to the treatment
- resulting in consent from the person legally able to give it without duress or without fraud
who is considered an adult?
someone who is over 18
*there ARE exceptions though, like a mature minor
who is considered competent?
generally someone who is not under a legal disability
someone who is under the age of 18 in most states who is old enough to understand the consequences of medial/dental care
mature minor
*may consent to some types of care in some states
a minor who has gotten married or is otherwise no longer subject to parental control or regulation and is not supported by their parents
emancipated minor
- the specific factors are usually established by statute and vary state to state
- encouraged to involve his/her parents or legal guardians
what is the rules for consent for emergency care?
none needed
can a statute grant the minor the right to consent, as in the case with HIV testing or consenting to an abortion
true
can a court give legal consent for treatment?
yes
which parent may provide consent if there is a divorce?
the dentist should rely on the parents to provide this information if the parents are legally separated or divorced
can grandparents give consent?
generally have no legal right to consent unless they are the court appointed legal guardians of the minor or have been given authority under a valid health care power of attorney
what are the 4 elements of informed consent?
- professional disclosure
- to the proper person
- at a time in reasonably proximity to the treatment
- resulting in consent from the person legally able to give it without duress or without fraud
should you have a witness present during disclosure?
yes
*a staff member can do the disclosing if the physician makes themself available for questions
what do you need to disclose to the pt?
- who will perform the procedure
- describe the procedure, including the dx, the nature and the purpose of the procedure
- describe the potential benefits of receiving the procedure, including the probability of success
- discuss the “material risks” that are inherent to the procedure (common risks)
- discuss risks taht may be improbable, but serious
- give the alternate methods of tx
- discuss consequence of doing nothing
what should you not disclose to the pt?
- guarantees or promises
- make no disclosure of the risks ONLY if the pt refuses to receive the risks in writing
- limit disclosure of risks ONLY when there is a substantial chance of harm to the pt, but disclose the risks to the appropriate pt representative if avaiable and justify the decision for alternate disclosure in the dental record
when the practitioner reasonably believes that full disclosure would be detrimental to the pts well-being (this would probs not occur in dentistry)
therapeutic privilege
are tx plans an alternative to consent?
no
when is “implied consent” allowed to happen
in a true emergency and NO authorized individual is available to give the necessary consent
breach of duty to disclose
breach of contract
what are 5 reasons why the consent may be invalid?
- the act of consent is unlawful
- the consent was given by one who has no legal right to give it
- the consent was gained by misrepresentations or fraud
- too vague
- extension of tx was beyond the scope of the extent
- involuntary or under distress
