By Sanette Viljoen
There have been quite a number of court cases recently about medical negligence. In many of these cases the issue of informed consent came up.
The real obligation of doctors and the rights of medical staff and their patients are taken to court again and again for consideration. This concept is also open for interpretation, which makes rulings in this regard very difficult.
Consent requires that the person who gives permission should know and understand exactly what he is letting himself in for. Because most patients are totally ignorant of medical matters, processes, options, etc, consent in these fields can only be given on the basis of the correct information.
In the absence of such information real consent will also be absent. The patient can therefore not give consent if he or she has not been properly informed. Even if the patient tells the doctor to “do what he wants”, this consent will not be good enough without proper information about the options and risks.
The doctrine regarding informed consent indicates that a patient may decide to agree to a certain treatment or to refuse a certain treatment after having been informed about the complications, the effect and the possible consequences of a certain treatment.
There are two objectives:
– Firstly, it is about the patient’s autonomy and freedom of choice. This is how it is ensured.
– Secondly, it is to encourage rational decision-making and to give the patient an opportunity to set off the advantages and disadvantages of a particular procedure in order to make an informed decision.
The doctor therefore has the following obligation:
– He or she must give the patient a general idea in broad terms in a language that a lay person understands.
– He or she must inform the patient about the nature, extent, consequences, risks, dangers, complications, advantages and disadvantages, prognosis, as well as the alternatives to this proposed treatment.
All serious and typical risks must be revealed and not necessarily unusual and highly improbable risks, except when a patient specifically asks about them.
The test for determining whether a certain risk is real and should be revealed in certain circumstances, is:
– firstly, whether the reasonable patient, should the information be available, would regard it as real. Is it something that the reasonable patient would want to know or should have known?
– secondly, whether the doctor within reason should be aware that this individual patient, should he be warned against this possible risk, would probably regard the risk or danger as real.
Therefore, make sure that your doctor explains all information about a treatment or procedure to you before you give your consent.