What Do You Need to Know About Informed Consent?

Informed consent is more than just a piece of paper to be signed before consenting to medical treatment. Informed consent means understanding the purpose, benefits, and potential risks of the medical treatment you choose to have. The flip side of informed consent is that a physician is also supposed to tell you what will happen if you choose not to be treated.

Whenever a physician proposes treatments for you, the physician is supposed to explain the treatment and be sure you understand the reasons for it. Informed consent is not just a piece of paper that you sign. Your understanding of the treatment choices should result from the discussion you have with your doctor.

Your physician is supposed to explain a procedure in a way that you can understand. There may be two or three procedures or treatments available to you. Your physician will tell you which procedure or treatment he or she prefers. The important point is that you, the patient, understand the explanations so you can decide which treatments being offered are the ones you are most comfortable with at the time.

Asking Questions of Your Physician

Sometimes it’s hard to ask questions of physicians. Don’t be shy. Let your physician know if you do not understand the explanation of the treatment being offered. You need to understand your treatment choices so you make a decision for a treatment you believe is the best one for you at the time.

There are times your physician may prefer one of the treatment choices over another, but you prefer a different one. Sometimes you may decide to try a less invasive treatment first before moving on to a more invasive treatment. Just remember that the final decision is yours, even if your physician might prefer a different option.

As the patient, you have the final say in your choice of treatment plans. That is a key element of informed consent. What this means is that it is the physician’s ethical obligation to support you in your choice, even if the physician believes a different treatment plan may be preferable.

Discuss your preferences with your doctor and as you do so, remember that you are the decision-maker in this process. A good provider will outline the risks and benefits of different treatment options, then support you in whatever choice you make. If you do not get the support you need with your decisions, there may be times when you should consider finding another doctor. If your provider makes you feel uncomfortable about your choice, consider going to another physician for a second opinion. This is your pregnancy, and your choice of treatment is up to you. If you and your doctor can’t agree on a treatment or procedure, you have the right to move on to another physician.

Outside Organizations Often Control Your Medical Decisions

There are many hospitals and payers — including insurance companies, Health Maintenance Organizations (HMOs), managed care, Medicare, and Medicaid — which have greatly eroded patient choice as well as physician choice by having the final say about whether a treatment will be covered or not and by controlling which physicians you may see. There may be times you find yourself in the situation where you may have to seek a doctor outside your list of possible physicians within your insurance group even if it will cost you more to go to a doctor outside the physician group you are assigned to in a HMO.

The first informed consent a pregnant woman will make is choosing what doctor to see during her pregnancy. Insurance companies should not have the ability to narrow the list of physicians, but unfortunately many women face this reality. It’s quite possible you prefer going to a doctor outside your insurance company’s chosen group.

Informed Consent is a Six-Part Process

Many pregnant mothers don’t know that informed consent — as defined by the American College of Obstetricians and Gynecologists (ACOG) — is a six-part process, with two steps for the patient and four steps for the physician. As you decide what is best for you and your pregnancy, it is important to keep these steps in mind.

According to ACOG, the two key components of informed consent for patients are

1.  understanding treatment options, and
2.  arriving at a treatment plan both you and your doctor can agree on.

For physicians, ACOG specifies four components:

1. the physician is obligated to help the patient,
2. the physician balances competing interests,
3. the physician is obligated to do no harm, and
4. the physician supports the patient’s decisions.

Discuss available treatment options with your doctor and choose a treatment plan both you and your physician agree on as being a good choice.

There are so many decisions and considerations to deal with during pregnancy, it can be tempting to assume the medical provider part of things is simpler that it actually is. In order to make choices for the kind of pregnancy and delivery you want, you need to familiarize yourself with all the various elements of informed consent.