Review of the Saudi Guidelines for informed consent in Surgery as well as the international best practice guidelines for a better approach to Informed Consent in the Kingdom of Saudi Arabia.
Review of the Saudi Guidelines for informed consent in Surgery as well as the international best practice guidelines for a better approach to Informed Consent in the Kingdom of Saudi Arabia.
In this presentation it has been tried to give a glimpse of different type of consent, how it should be taken, how the patient to be explained, when consent is must and conditions where consent is not required, so as to guide you in your every day practice.
Series of lectures I gave for the PEER (Professionalism and Ethics Education for Residents) Project sponsored and organized by the Saudi Commission for Health Specialties (SCHS).
OUTLINE:
What is an informed consent to treatment?
What is the elf basis to consent?
What makes the consent an ethically valid one?
Types of Consent
When it is needed? When could it be waived?
How to take an informed consent?
What if the patient is not able to give consent?
Documentation of Consent
Special Issues about Consent
Now-a-days public are expecting Skills, Knowledge as well as Ethical behaviour from Doctors. This PPT gives the 2 basic principles of Bio-ethics in brief & apt form
In this presentation it has been tried to give a glimpse of different type of consent, how it should be taken, how the patient to be explained, when consent is must and conditions where consent is not required, so as to guide you in your every day practice.
Series of lectures I gave for the PEER (Professionalism and Ethics Education for Residents) Project sponsored and organized by the Saudi Commission for Health Specialties (SCHS).
OUTLINE:
What is an informed consent to treatment?
What is the elf basis to consent?
What makes the consent an ethically valid one?
Types of Consent
When it is needed? When could it be waived?
How to take an informed consent?
What if the patient is not able to give consent?
Documentation of Consent
Special Issues about Consent
Now-a-days public are expecting Skills, Knowledge as well as Ethical behaviour from Doctors. This PPT gives the 2 basic principles of Bio-ethics in brief & apt form
This is the introductory session in Seminars and Practical Activities in the Medical Ethics & Professionalism course at Al-Farabi Colleges in Riyadh (25.09.2016)
L3. Section III: Western and Islamic approach to ethics and ethical reasoning. A lecture given to medical students at AlFarabi medical Colleges in Riyadh (05.10.2016)
Overview on Islamic Bioethics. This is the second part of the introduction to medical ethics. It was delivered to the medical students at Al-Farabi Medical Colleges in Riyadh
this is a discussion not a paper I need a paragraph under each quest.docxabhi353063
this is a discussion not a paper I need a paragraph under each question. each paragraph need to be at least 250 words with up to date references.
HAS 515 Week 8 Lecture:
Patient Rights and Responsibilities and Acquired Immunodeficiency Syndrome
Slide #
Scene/Interaction
Narration
Slide 1
Intro Slide
Slide 2
Scene 1
Professor Charles enters classroom and introduces the topics for today’s lesson and begins the lecture.
Prof Charles
: Hello everyone….welcome back to class. Today, we are going to discuss patient rights and responsibilities and acquired immunodeficiency syndrome.
The Patient Self-Determination Act of 1990 (PSDA) made a significant advance in the protection of the rights of patients to make decisions regarding their own health care. Healthcare organizations may no longer passively permit patients to exercise their rights but must protect and promote such rights. The PSDA provides that each individual has a right under state law to make decisions concerning his or her medical care, including the right to accept or refuse medical or surgical treatment and the right to formulate advance directives.
Let’s first discuss the rights of the patient. How are patient rights classified?
Casey:
Patient rights may be classified as either legal (those emanating from law) or human statements of desirable ethical principles (such as the right to healthcare or the right to be treated with human dignity). Both staff and patients should be aware and understand not only their own rights and responsibilities, but also the rights and responsibilities of each other.
Donald
: Patients also have a right to receive a clear explanation of tests, diagnoses, treatment options, prescribed medications, and prognosis; participate in healthcare decisions; understand treatment options; and discontinue or refuse treatment options. It is recognized that the relationship between the physician and the patient is essential for the provision of proper care.
Casey
: In addition to what has already been noted, I would say that legal precedent has established that not only does the institution have responsibility to the patient, but also the patient has responsibility to the institution.
Prof. Charles
: Absolutely… What does the federal and state law and the Constitution have to say about discriminatory practices?
Casey
: Most federal, state and local programs specifically require, as a condition for receiving funds under such programs, an affirmative statement on the part of the organization that it will not discriminate. For example, Medicare and Medicaid programs specifically require affirmative assurances by healthcare organizations that no discrimination will be practiced. Healthcare organizations who do not comply may lose Medicare and Medicaid certification and reimbursement.
Prof. Charles
: Excellent. What is an example of discrimination by a hospital?
Donald:
There was a case,
Stoick v. Caro Community Hospital
, where the patient brought a medical ...
A Woman Who was Forced to offer her kidney” This was a case of a woman of 22 years of age who came to donate a kidney for our patient who was supposedly her brother. She was a good match, but I strongly suspected that she was not related and was either being coerced or being paid to donate the kidney. We have a policy against doing transplants from unrelated donors. We make it very clear that we will consider a transplant only if the donor is related to the recipient and is not doing it for gain. I asked her several times but she said that she was his sister. I still had my suspicions, so I sent her to a psychiatrist for assessment. She was of subnormal intelligence and did not understand the procedure. We could have refused to do the operation here, but they would have gone to some other center and had it done anyway. So, we carried out the operation. Much later, we learned that she was a paid, distantly related person who was possibly forced by her family. We are trying to avoid that this becomes a commercialized process of buying and selling goods in the market.
Public profile of homoeopathy– the evidence base for homoeopathic prescribingGyandas Wadhwani
As a specialized system of therapeutics and pharmacology, homoeopathy, has withstood all possible criticism, from quackery to witchcraft and placebo to nocebo. Attempts have been made to curb the rising popularity through all the articles and data analysis proving or disproving homoeopathy, especially published in ‘the lancet’, over last few decades.
One of the learned physicians once said about homoeopathy, ‘It is the medicine of the ten percent’. But is it really so? The trends across the globe highlight an increasing inclination towards homoeopathy.
In spite of numerous publications, reviews and researches condemning all that is known as homoeopathy, the financial sector has been a boom in business worldwide. But is it a bubble about to burst?
How to make a fruitful and perhaps lasting, or at least unforgotten, impact on the world? Research, says the researcher; advertise, says the practitioner with a chain of clinics; laboratory experimentation with reproducibility, says the scientist; treat larger number of patients, says the practitioner. Is it enough?
Lately the homoeopathic research scientists are throwing weight behind the works of Archibald Leman Cochrane, widely regarded as the father of ‘Evidence based medicine’. Will it keep the vultures at bay?
Let us join hands and pledge to stand firmly together and forever, silence one and all, for this system of specialized therapeutics offers multum in parvo. Together we can uplift the profile of homoeopathy for public at large.
Do Not Resuscitate Orders : What They Mean ?SMSRAZA
Most doctors working in Acute areas know when and how to do CPR. However, most get stuck when it comes to ' When not to do CPR' due to cultural, social, ethical and legal issues attached.
AETCOM module: Bioethics for Undergraduate Medical Studentslavanyasumanthraj
The Attitude, Ethics & Communication module introduced by the National Medical Commission is being followed in Medical Colleges. Here's a simple understanding of aspects on Bioethics & solution to Phase 2 MBBS modules
Similar to Lecture 11 informed consent to treatment (20)
نظرية التطور عند المسلمين (بروفيسور محمد علي البار
ويقدم فيها سردا تاريخيا لنظريات نشأة الخلق وخلق آدم وكيف ان نظرية التطور هي نظرية علمية وليس دينية لكن تم استغلالها لمحاربة الكنيسة
Ethical considerations in research during armed conflicts.pptxDr Ghaiath Hussein
My talk @AUBMC Salim El-Hoss Bioethics Webinar Series. In this webinar, we have discussed the following points:
1- How armed conflicts affect the planning and conduct of research?
2- What is ethically unique about research during armed conflicts?
3- How did my doctoral project approach these ethical issues both at the normative and the empirical levels?
4- What are the lessons learned from the conflicts in the middle east (Sudan, Syria, Yemen, etc.) and how do they differ from the situation in Ukraine?
Acknowledgement: This talk is based on my doctoral thesis (http://etheses.bham.ac.uk/8580/), which was fully funded by Wellcome Trust, UK.
Research or Not Research? This Is Not the Question for Public Health Emergencies
November 17, 2021 @ 4:00 pm - 5:00 pm EST
Speaker:
Ghaiath Hussein, Assistant Professor, Medical Ethics and Law, Trinity College Dublin, Ireland
About this Seminar:
Public health emergencies, whether natural or man-made, local or global, in peacetime or during armed conflicts are always associated with the need to collect data (and sometimes biological samples) about and from those affected by these emergencies. One of the central questions in the relevant literature is whether the activities that involve the collection of data and/or biological samples are considered ‘research’, with the subsequent endeavour to define what ‘research’ is and whether they should be submitted for ethical approval or not. In this seminar, I will argue that this is not the central question when it comes to research/public health/humanitarian ethics. Using the findings of a systematic review on the research conducted in Darfur and findings from a qualitative project that aimed at defining what constitutes ‘research’ in public health emergencies I will, alternatively, present what I refer to as the ‘ethical characterization’ of these research-like activities and how they can be ethically guided.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
1. Asst. Prof. of Medical Ethics
Alfarabi Medical College
Dr. Ghaiath M. A. Hussein
Ethical, Legal & Fiqhi Issues
Consent to Treatment
2. Outline
What is an informed consent to treatment?
What is the ELF basis to consent?
What makes the consent an ethically valid one?
Types of Consent
When it is needed? When could it be waived?
How to take an informed consent?
What if the patient is not able to give consent?
Documentation of Consent
Special Issues about Consent
3. CASE
Mrs. Cope, the 42-year-old woman with insulin-dependent
diabetes, is brought by her husband to the emergency
department. She is stuporous, with severe diabetic
ketoacidosis and pneumonia.
Physicians prescribe insulin and fluids for the ketoacidosis and
antibiotics for the pneumonia.
Although Mrs. Cope was generally somnolent, she awoke while
the IV was being inserted and stated loudly: "Leave me alone.
No needles and no hospital. I'm OK."
Her husband urged the medical team to disregard the patient's
statements, saying, "She is not herself."
4. What is an informed consent?
Informed consent is the process by which a fully
informed patient can participate in choices about
his/her health care.
Informed consent is a consent obtained freely,
without threats or improper inducements, after
appropriate disclosure to the patient of adequate
and understandable information in a form and
language understood by the patient.
5. Why to Take Consent?
Ethically: it reflects the ethical principle of respect of
autonomy. It establishes trust in the healthcare providers.
Legally: It expresses the right of people to make informed
decisions about health treatment. It is against the law to
interfere with people’s bodies without their consent.
Fiqhi: In Shariah, every adult has his/her competence
(Zimma) to take permissible (Mobah) decisions related to
his/her life, unless there are genuine causes to assume the
opposite.
8. When is Consent Needed?
Consent would include any procedure undertaken for the purpose
of treatment :
1. Diagnosis
2. Anesthesia
3. Fluid infusion
4. Blood transfusion
5. Any operation
6. Any form of medical/ surgical treatment
9. What is the Treatment that Needs Consent?
Anything that is done for a therapeutic, preventive, palliative,
diagnostic, cosmetic, or
Other health related purpose by any health practitioner (doctor,
nurse, physiotherapist, etc.), and
Includes a course of treatment or plan of treatment.
10. When consent isn't needed
• It may not be necessary to obtain consent if a person:
• requires emergency treatment to save their life, but
they're incapacitated
• immediately requires an additional
emergency procedureduring an operation –
• with a severe mental health condition – such
as schizophrenia, bipolar disorder or dementia – lacks the
capacity to consent to the treatment of their mental health
• is a risk to public health (notifiable disease)
• is severely ill and living in unhygienic conditions - a person
who is severely ill or infirm and is living in unsanitary
conditions can be taken to a place of care without their
consent
11. Conditions for a Consent to be Valid?
Capacity
Understand
Appreciate
Remember
Communicate
Disclosure
Relevant information
Understandable
Voluntariness
Free from undue
influence
No coercion
12. Conditions for a Consent to be Valid?
• "Disclosure" refers to the provision of relevant information by
the clinician and its comprehension by the patient.
• "Capacity" refers to the patient's ability to understand the
relevant information and to appreciate those consequences of
his or her decision that might reasonably be foreseen.
• "Voluntariness" refers to the patient's right to come to a
decision freely, without force, coercion or manipulation.
• It must not be obtained through misrepresentation or fraud
14. Presumption of Capacity
A patient is presumed to be capable unless a health practitioner
(e.g., doctor, nurse, physiotherapist) has reasonable grounds to
believe the patient is incapable to consent to the specific
treatment they are proposing.
Give examples of “reasonable grounds ” to doubt’s a patient’s
capacity?
15. Conditions to Capacity
A person is capable under the if:
1. They are able to UNDERSTAND
The condition from which the treatment is proposed.
The nature of the proposed treatment.
The risk and benefits of the proposed treatment.
The alternatives of the treatment presented by the health
practitioner including the alternative of not having the
treatment.
16. Conditions to Capacity Cont…
A person is capable under the if:
As per the Health Care Consent Act of Canada
2. They are able to APPRECIATE the reasonably foreseeable
consequences of a decision or lack of decision by:
Acknowledge how the recommended treatment may
affect them.
Assessing how the proposed treatment and alternatives,
including the alternative of not having the treatment, could
affect their quality of life.
Their choice of treatment, is not substantially based on
delusional belief.
Findings from the capacity assessment should be
documented in the progress notes as the time of each consent
process.
17. CASE
Mrs. Cope, the 42-year-old woman with insulin-dependent
diabetes, is brought by her husband to the emergency
department. She is stuporous, with severe diabetic
ketoacidosis and pneumonia.
Physicians prescribe insulin and fluids for the ketoacidosis and
antibiotics for the pneumonia.
Although Mrs. Cope was generally somnolent, she awoke while
the IV was being inserted and stated loudly: "Leave me alone.
No needles and no hospital. I'm OK."
Her husband urged the medical team to disregard the patient's
statements, saying, "She is not herself."
18. DISCUSSION
Mrs. Cope has an acute crisis (ketoacidosis and pneumonia)
superimposed on a chronic disease (Type I Diabetes) and she
demonstrates progressive stupor during a two-day period.
At this time, she clearly lacks decisional capacity, although she
could make decisions two days prior to the onset of her illness,
and she could possibly make her own decisions again when she
recovers from the ketoacidosis, probably within the next 24
hours.
19. Discussion Cont.
At this moment, it would be unethical to be guided by
the demands of a stuporous individual who lacks
decision-making capacity. The cause of her mental
incapacity is known and is reversible.
Physicians and surrogate concur on the patient's
incapacity and are agreed on the course of treatment in
accordance with the patient's best interest. The
physicians would be correct to be guided by the wishes
of the patient's surrogate, her husband, and to treat
Mrs. Cope over her objections.
21. Disclosure
Patient must receive information on the:
Nature and the process of the intervention
Nature of the treatment
The diagnosis and the prognosis
Expected benefits of the treatment
Material risks of the treatment
Material and possible undesirableside effects
Alternative course of action
Possibilities, benefits and risks of alternative
interventions
Likely consequences of not having the treatment
21
22. Tips to Disclosure
In carrying this information physician should:
Avoid technical terms
Attempt to translate statistical data into everyday probabilities
Enquire whether patient understand the information
Interpret other information that patient has to ascertain its
relevance
Use language appropriate to the patient's level of understanding
in a language of their influency
Pause and observe patients for their reactions
Invite questions from the patient and check for understanding
23. Comprehension
Invite the patient to share fears, concerns, hopes and
expectations
Watch for patients' emotional response: verbal and non-verbal
Show empathy and compassion
Summarize the imparted information
Provide contact information (and other resources)
Explanation should be given clearly and simple questions asked
to assess understanding
Written instructions or printed materials should be provided
CD or video given if necessary
25. Voluntariness:
Refers to a participant’s right to make treatment decisions free of any undue
influence.
Influences include:
Physical restraint or sedation
Coercion involves the use of explicit or implicit threat to ensure that the
treatment is accepted
Manipulation involves the deliberate distortion or omission of information
in an attempt to induce the patient to accept a treatment
Undue financial payment
Undue influence (Emotional?)
Fear of injury
Misconception of fact
25
27. Documentation of Consent
A consent may be expressed or implied
Example: A patient may imply consent to have a lacerated arm
sutured as proposed by the physician, by holding out the
arm, but the consent must be documented in the
progress note by the health practitioner obtaining it,
e.g., Mr. Smith agreed to sutures.
The rule is that consent to treatment should be written and
reported in the patient’s record, except when this is not possible.
29. Who May not be Able to Consent?
Emergency
Children (& adolescents?)
Alcohol or substance abuse
Mentally disabled
Others?
30. Consent and Refusal of Treatment for
Incompetent Adults and Children
Consent for children
Competent children can consent to treatment but cannot
refuse treatment. The consent of one parent is sufficient if
the other one disagrees. Parental choice takes precedence
over the child's choice.
Life-saving treatment of minors is given even if parents
refuse. Parental choice is final in therapeutic or non-
therapeutic research on children.
Advocacy Centre for the Elderly 2010 30
31. Consent and Refusal of Treatment for
Incompetent Adults and Children Cont.
Consent for children Cont.
Assent: A child’s affirmative agreement to participate (without
meeting all of the full consent elements)
The mere failure to object, absent affirmative agreement,
should not be construed as assent.
Advocacy Centre for the Elderly 2010 31
32. Mental Patients
Mental patients cannot consent to treatment, research, or
sterilization because of their intellectual incompetence. They are
admitted, detained and treated voluntarily or involuntarily for
their own benefit, in emergencies, for purposes of assessment if
they are a danger to themselves, or on a court order. Suicidal
patients tend to refuse treatment because they want to die.
33. The unconscious
For patients in coma proxy consent by family members can be
resorted to. If no family members are available, the physician does
what he as a professional thinks is in the best interest of the
patient.
Advocacy Centre for the Elderly 2010 33
34. Obstetrics
Labor and delivery are emergencies that require immediate
decisions but the woman may not be competent and proxies are
used. Forced medical intervention and caesarean section may be
ordered in the fetal interest. Birth plans can be treated as an
advance directive.
Advocacy Centre for the Elderly 2010 34
35. Advocacy Centre for the Elderly
2010
35
General Challenges to Patient-Physician
Communication
Time constraints
Language differences
Mismatch of agendas
Lack of teamwork
Discomfort with strong emotions
Quality of physician training
Resistance to change habits
Buckman (1984), Ford et al (1994), Buss (1998)
36. Watch the Differences on How we Make
Decisions
The Patient The Health Care Professional
Values and priorities
Culture
Religious beliefs
Desire for information and
control personality and
coping style
Roles: spouse, parent,
child, provider
Degrees of dependence
upon and trust in the
professional
Education
knowledge
experience
communication style
values and priorities
demographic profile
( e.g. gender, age )
37. Difficulties With Informed Consent
Many studies reveal that physicians consistently fail to
conduct ethically and legally satisfactory consent
negotiation.
Physicians may be having the following problems
1. Use of technical language
2. Uncertainties intrinsic to all medical information
3. Worried about harming or alarming the patient
4. Hurried and pressed by multiple duties
39. Take home message
Informed consent is a process of communication
between a clinician and a Patient/Patient
Representative.
It is not simply a matter of obtaining a patient's
signature on a consent form.
40. References
Presentation by : Prof. Omar Kasule
Dr. Datuk Dr. Ahmad Tajudin Jaafar
Health Care Consent and Advance Care Planning - Getting it
Right, by: Judith Wahl, B.A., LL.B. & Barrister and Solicitor -
Advocacy Centre for the Elderly
Consent and assent in the adolescent and young adult with
cancer by: Conrad Fernandez MD, FRCPC