Patients have appreciated the enhanced clarity, and no malpractice claims have been raised. The aforementioned model was first introduced into our everyday practice about 1 year ago ( Figure 1), and we have found it to be extremely productive and beneficial. In order to improve and reestablish an unproblematic relationship between patients and medical institutions, it would be better if the information is given well in advance of the operation 3 and if specific consents were defined for each different procedure.
Such solutions clearly demand a surgeon's patience and availability for explanations. Moreover, on the consent form, it must be possible to formalize a patient's refusal of treatment, which can occur even in cases of proper elucidation the “disagree” option should also be present, so that even an adequately informed patient may refuse the suggested treatment. Thus, no future complaints predicated on misunderstanding and lack of preoperative information can result. Only positive comments such as “good,” “very good,” and “excellent” will indicate understanding and readiness for surgery.Īdditionally, the patient will be provided sufficient time to assess his or her level of understanding and awareness of the operative risks. The proposal is to insert the question, “How do you evaluate both the written and oral information provided?” and have patients fill in their answer in the space provided next to the question. This scenario is why we felt the need for a consent document that includes the patient's self-assessment of his or her understanding. This is such a risky deficiency that the surgeon may be prosecuted even if information has been properly disseminated, due to a patient's later denial of either sufficient comprehension (“If I had understood, I would have never undergone the procedure!”) or time (“I did not have time enough to read the consent form carefully.”). A standard informed consent does not indicate evidence of effective communication and thorough understanding on the patient's part at the time of signing a signed informed consent does not prove the patient has fully understood its content. The success of informed consent is based not only on the surgeon providing adequate information but also on the patient thoroughly understanding the procedure and process. Such lack of information opens the door to possible future malpractice claims. Nevertheless, patients usually tend to sign the consent form to accelerate the process. As a result, the surgeon deprives patients of information they deserve. Despite this, the everyday clinical process may offer a different scenario: the legal formula of informed consent often becomes a mere act of hurriedly signing a form. 2 Well-informed patients generally have good compliance and few anxieties and malpractice claims to raise. In fact, this aspect of the process allows patients to take active part in their own health care.
1 Surgeons have the moral and legal obligation to adequately clarify for their patients everything concerning such operations and cannot perform any procedure without written patient consent. This-arguably, the result of a progressive lack of communication between surgeons and patients-becomes apparent in inadequate informed consent, as previously highlighted by Patel et al. Patient demand and expectations for plastic surgery have significantly increased over recent decades, leading to an increasing trend in claims.
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