What is Informed Consent?

The dentist should inform the patient of the proposed treatment, and any reasonable alternatives, in a manner that allows the patient to become involved in treatment decisions. - Section 1A of the American Dental Association Principles of Ethics and Code of Professional Conduct, copyright 1995-2009.

There is a lot of paper work that goes along with any medical or dental procedure. Informed consent may be the most important. Patients should understand the procedure they are preparing for and possible outcomes. Patients should also understand that physicians and dentists use informed consent to perform a dual purpose - inform their patient and protect themselves in case of legal action.

On paper, the requirements for informed consent are relatively simple. Of course, there is room for interpretation. Informed consent must be in language a patient understands. There must be a full description of the recommended treatment, the risks and benefits of that treatment, and alternative treatments including non-treatment.

Some doctors assign staff members to begin the informed consent process. Doctors and staff may provide printed material, video recordings, and verbal descriptions to educate the patient. However, the most important requirement is that the patient must have the opportunity to ask the doctor questions and the doctor must answer those questions before the procedure begins.

When is the best time for informed consent? The patient should have enough time to read about the procedure and digest the information. Many patients may have the experience of receiving informed consent immediately before a complicated procedure. This is reasonable in an emergency. It is just as reasonable, but less preferable, for the doctor to write that the patient is informed and all questions were answered.

While the patient may sign a paper, there is no legal requirement for the doctor to collect that signature. The advantage of written informed consent for the doctor is that there is an indisputable record that the patient was informed. The advantage of written informed consent for the patient is that the patient is able to see the information they need in writing and they may keep that information for future reference. The advantage for the doctor is that there is a firm record that the patient is informed and consent is obtained.

Who may give their informed consent to a procedure? Any adult patient with appropriate decision-making capacity may grant their consent to a procedure. The Committee on Bioethics of the American Academy of Pediatrics instructs their members that they should attempt to gain assent or agreement from a minor patient, but they must obtain consent from the child's parent or legal guardian. (PEDIATRICS, Volume 95 Number 2, Pages 314-317, February 1995.)

What information does informed consent include? It is a good idea for the patient to understand the condition that they are undergoing treatment for. Most patients will appreciate a description of the procedure or treatment. This need not be a step-by-step set of instructions, but may include diagrams, photographs, and videos.

The risks and benefits section must include any major risks. Informed consent need not include risks that are very unusual. Patients must understand that it is impossible to know every risk.

Alternative treatments should include reasonable alternatives. This does not include treatments that are unlikely to affect the condition or disease or experimental treatments. One alternative that doctors always include is the risks and benefits of no treatment.Finally, when you are planning to undergo a medical or dental procedure, feel confident to take the time to ask the doctor any questions that will help you understand the procedure before signing for informed consent. There are a lot of pieces of paper that require your signature, but this piece of paper is a very important one.