INFORMED CONSENT ADVANTAGES FEATURES STYLES ADVANTAGES OF INFORMED

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INFORMED CONSENT ADVANTAGES FEATURES STYLES

INFORMED CONSENT ADVANTAGES FEATURES STYLES

ADVANTAGES OF INFORMED CONSENT • CREATES A BOND OF MUTUAL TRUST BETWEEN PATEINT AND

ADVANTAGES OF INFORMED CONSENT • CREATES A BOND OF MUTUAL TRUST BETWEEN PATEINT AND PHYSICIAN BY OPENING IMPORTANT PATHWAYS OF COMMUNICATION • HELPS PATIENTS TAKE A GREATER MEASURE OF RESPONSIBILITY IN THE COURSE OF THEIR TREATMENT BY HAVING MORE EXTENSIVE KNOWLEDGE OF THEIR CONDITION AND ITS IMPACT ON THEIR PERSONAL LIFESTYLE • ALLOWS THE PHYSICIAN TO CARE FOR PATIENTS MORE EFFECTIVELY BY HAVING MORE COMPLETE INFORMATION ABOUT PATIENTS INCLUDING THE VALUE BASIS FOR GRANTING OR WITHHOLDING CONSENT • REDUCES THE LIABILITY EXPOSURE OF PHYSICIANS BY MAINTAINING AVENUES OF COMMUNICATION WHEREBY CONFLICTS CAN BE RESOLVED WITHIN THE RELATIONSHIP WITHOUT THE NECESSITY OF HAVING RECOURSE TO THE COURTS

GENERAL COMPONENTS OF INFORMED CONSENT • CONDITION – DIAGNOSIS – PROGNOSIS – AVAILABLE TREATMENTS

GENERAL COMPONENTS OF INFORMED CONSENT • CONDITION – DIAGNOSIS – PROGNOSIS – AVAILABLE TREATMENTS • PROPOSED TREATMENT – – – NATURE PURPOSE RISKS BENEFITS REASONABLE ALTERNATIVES COST? ? ?

INFORMED CONSENT PRESIDENT’S COMMISSION (1982) • INTEGRAL PARTY OF A PLURALISTIC SOCIETY WITH MULTIPLE

INFORMED CONSENT PRESIDENT’S COMMISSION (1982) • INTEGRAL PARTY OF A PLURALISTIC SOCIETY WITH MULTIPLE VIEWS OF THE “GOOD LIFE” • BASIC VALUES UNDERLYING INFORMED CONSENT – PERSONAL WELL-BEING – SELF-DETERMINATION – SHARED DECISION MAKING --- MUTUAL RESPECT • PRESUMPTION OF CAPACITY TO MAKE DECISIONS • CAPCITY IS SPECIFIC TO EACH DECISION • CONSULTATION IN CASES OF INCAPACITY – INFORMATIVE BUT NOT DETERMINATIVE

LEVELS OF RECEIVING INFORMATION • FACTS – PATIENT IS MERELY ACQUAINTED WITH A BODY

LEVELS OF RECEIVING INFORMATION • FACTS – PATIENT IS MERELY ACQUAINTED WITH A BODY OF FACTUAL KNOWLEDGE WHICH MAY BE FAIRLY DISCRETE AND UNRELATED • UNDERSTANDING – PATIENT HAS MASTERED THE FACTS AND IS ABLE TO SEE THE RELATIONS BETWEEN THEM “AT A DISTANCE” • PROCESSING – PATIENT HAS INTEGRATED FACTS INTO HIS/HER VALUE CONTEXT

EXCHANGE OF POWER • INFORMATION EMPOWERS THE PATIENT • CONSENT EMPOWERS THE PHYSICIAN •

EXCHANGE OF POWER • INFORMATION EMPOWERS THE PATIENT • CONSENT EMPOWERS THE PHYSICIAN • DYNAMICS OF NEGOTIATION ARE ESSENTIAL TO RELATIONSHIPS OF POWER

MODELS OF IMPLEMENTING INFORMED CONSENT EVENT MODEL • • DISCRETE ACT MINIMAL LEGAL REQUIREMENT

MODELS OF IMPLEMENTING INFORMED CONSENT EVENT MODEL • • DISCRETE ACT MINIMAL LEGAL REQUIREMENT CONSENT FORM AS A SYMBOL HOW MUCH DO PATIENTS TRULY UNDERSTAND?

MODELS OF IMPLEMENTING INFORMED CONSENT PROCESS MODEL • • ACTIVE PATIENT PARTICIPATION IN DECISION

MODELS OF IMPLEMENTING INFORMED CONSENT PROCESS MODEL • • ACTIVE PATIENT PARTICIPATION IN DECISION MAKING ROLE EXPECTATIONS OF PHYSICIANS AND PATIENTS IMPORTANCE OF PATIENT’S PERSONAL AND VALUE HISTORY PATIENT RESPONSIBILITY MUTUAL MONITORING CONTINUAL DIALOGUE CONTINUAL RUMINATION AND REORDERING OF KNOWLEDGE IN LIGHT OF NEW INFORMATION AND EXPERIENCE

STRATEGIES FOR PROCESS MODEL • • ESTABLISH RESPONSIBILITY DEFINE PROBLEM SET GOALS FOR TREATMENT

STRATEGIES FOR PROCESS MODEL • • ESTABLISH RESPONSIBILITY DEFINE PROBLEM SET GOALS FOR TREATMENT SELECT APPROACH TO TREATMENT FOLLOW-UP IN EXTENDED TREATMENT SOLICIT PATIENT REFLECTIONS ACKNOWLEDGE PERSONAL AUTONOMY AS NORMAL PART OF PROCESS OF GETTING WELL OR MANAGING A DISEASE PROCESS

COMMUNICATION AND INFORMED CONSENT • GIVING ACCURATE INFORMATION • GIVING INFORMATION IN AN UNDERSTANDABLE

COMMUNICATION AND INFORMED CONSENT • GIVING ACCURATE INFORMATION • GIVING INFORMATION IN AN UNDERSTANDABLE WAY • PROCESSING INFORMATION IN PATIENT’S VALUES AND GOALS • EXPLORING FEELINGS • SHARING RESPONSIBILITY • AVOIDING EUPHEMISMS AND DOUBLE MESSAGES • SUPPORTING PATIENT IN THE DECISION