![]() ![]() If the patient's ability to make decisions is questioned or unclear, an evaluation by a psychiatrist to determine competency may be requested. Several exceptions to the requirement for informed consent include (1) the patient is incapacitated, (2) life-threatening emergencies with inadequate time to obtain consent, and (3) voluntary waived consent. However, it is the sole obligation of the provider to determine which approach is appropriate for a given situation. Many states use the "reasonable patient standard" because it focuses on what a typical patient would need to know to understand the decision at hand. The three acceptable legal approaches to adequate informed consent are (1) Subjective standard: What would this patient need to know and understand to make an informed decision? (2) Reasonable patient standard : What would the average patient need to know to be an informed participant in the decision? (3) Reasonable physician standard : What would a typical physician say about this procedure? The required standard for informed consent is determined by the state. The provider must make a recommendation and provide their reasoning for said recommendation. ![]() It is the obligation of the provider to make it clear that the patient is participating in the decision-making process and avoid making the patient feel forced to agree to with the provider. The Joint Commission requires documentation of all the elements of informed consent "in a form, progress notes or elsewhere in the record." The following are the required elements for documentation of the informed consent discussion: (1) the nature of the procedure, (2) the risks and benefits and the procedure, (3) reasonable alternatives, (4) risks and benefits of alternatives, and (5) assessment of the patient's understanding of elements 1 through 4. ![]() Implicit in providing informed consent is an assessment of the patient's understanding, rendering an actual recommendation, and documentation of the process. Informed consent is both an ethical and legal obligation of medical practitioners in the US and originates from the patient's right to direct what happens to their body. The patient must be competent to make a voluntary decision about whether to undergo the procedure or intervention. Informed consent is the process in which a health care provider educates a patient about the risks, benefits, and alternatives of a given procedure or intervention. ![]()
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