Informed Consent

• Components of Informed Consent
  • Capacity
  • Disclosure of information
    • Details
      • The procedure for which the patient is being consented: The procedure should be explained in detail, including positioning, incisions and the basic steps of the procedure.
      • The indication for procedure: Why the procedure is being done?
    • Benefits
      • Benefits of the procedure: What are expected success rates? Why is this beneficial to the patient over other options?
    • Risks
      • Potential risks of the procedure: Care should be taken not to over- or understate risks.
      • What to expect post-procedure: including recovery, bleeding and would healing.
    • Alternatives
      • Alternatives to the procedure: including no intervention.
  • Voluntariness
  • Authorization
• Language tailored to patient needs
• Presenting information in balanced fashion
• Invitation of questions
• Verification of understanding
• Sometimes discussing the alternative is key
  • Balance information
  • Understating
  • “Scare tactics”
• The “right amount” of information to give is a forever moving target
• Does not preclude recommendation!
  • “In this situation we would typically…”
  • “Standard practice would be… and here’s why…”
  • “Based on what you’ve said about wanting to feel better as fast as possible I would recommend…”

Error Disclosure

• Patients Preferences
  • Error occurred
  • What happened
  • How it happened
  • Expression of concern
• State facts without blame or conjecture
  • What happened
  • Consequences
• Express Empathy
• Align that goal is best possible care
• Apologies
  • Helpful part of being a human (empathy and contrition)
  • Blameless apology
    • “I’m really sorry that this happened”