Anyone who has been given a diagnosis and recommended treatment has to make a decision. But how is that decision made? What facts are provided?

My experience and assessment of the professional state of the art: not enough.

During the years I spent writing my book The Patients’ Time Has Come, I recognized as a former professional nurse, I wasn’t given any opportunity or provided any information about choices that would influence my decision-making when I confronted a major life-threatening cardiac event. I was the one trying to champion my own cause and requesting the care I knew I needed!

As a result, I decided to help others by writing a book I thought would comprehensively detail what patients need to know and what professionals can do to help patients. The following is a brief outline about one issue I wanted developed.

One chapter of my book, “Increasing Patient Power and Knowledge,” outlines many facets about what constitutes consent and the process this requires.  Those who’ve given any consideration to this topic, either from their own personal or professional experience in the health care system, or any research they’ve done on this topic, can likely attest; there is much work to be done to improve the consent to treatment process when it comes to both accountability and transparency.

Problem: trust can lead to unwarranted assumptions. “Much of what transpires in the relationship between a patient and the professional (of any designation) is based on trust. Within the realm of trust are assumptions, yet many patients’ assumptions about the professionals providing care aren’t discussed. Likewise, many potential problems relating to the professionals or the hospital go undisclosed by those obtaining consent.” [2]

Full Disclosure Means Transparency: what should constitute a written consent to treatment?

• Facts first: patients need information and facts about the condition, recommended surgical procedures or invasive medical procedures (such as PICC, CVC, spinal tap, bone marrow) with appropriate patient educational aids, medications with an educational guide[3] per class of drug, outline and preparation for any discharge planning, information and credentials about the professionals providing surgical or medical care and those providing daily service are all consent to treatment details that are needed. Just a few ideas and suggestions about what this chapter extensively covers.[4]
• Video recording: requires signed consent for using Google Glass, during surgical procedures or office visits. Patients should be given a copy of any authorized video recording for their own personal record.
• Clinical Checklists: are essential and patients should request these be made available so they can assist staff to ensure nothing is overlooked.
• Patient Recorded Data: patients need to record into their own hospital chart in real time so staff and administration can review their status from the patient’s (or their surrogate/advocate) point of view so attentive care can be given, oversights are minimized and corrections can be made.

Patients’ Rights Issue?

“There is no current recommendation or provision in the Consent to Treatment regulation process[5] that ensures patients’ input be a vital and valued part of its revision.”

Consultant Reports and Consent to Treatment Accuracy

All professionals of any designation should carefully assess what they write when acting as a consultant and while doing client/patient reports by considering that:

• Incorrect or biased information can affect insurance claims or even entry into another country.
• Patients can lose control over their lives if documents include decisions and comments made without their knowledge or consent.
• Any consultant’s letter can be a powerful weapon adversely affecting a patient’s right to obtain insurance or getting opportunities for a career.

Your Preferred Choice:  Implied or Defined Consent for Care?[6]

• Name all staff who care for patient, list of professional qualifications, provide reconciliation of tests, educational aids for understanding medications, discharge planning inclusions: information about medications and devices, implants, tools, guides, reporting of concerns, “how to” deal with public relations issues, use of surveys, tools and templates.
• Requirements for collaborative efforts, includes: participation in referral letters, patient health care contracts, patients having access to using a self-referral process to consultants, patient care contracts and more.

This two page descriptive summary is a condensed version (from 50 pages) about what is needed to update the consent to treatment document so patients sign a document worthy of its signature, one that outlines and defines the care the patient will receive, that to which they agreed, and one that offers their ongoing verification that the care they received was to a standard they’d anticipated.

To order my book (print or e-book) please visit my website: ElizabethRankin.com.

I welcome any comments or questions at: medawarepublications@gmail.com or through SPM: lizrankin43@gmail.com

Footnotes

[1] This article is based on one chapter of my book, The Patients’ Time Has Come (Canada: Med-Aware Publications, 2016).

[2] Rankin, The Patients’ Time Has Come, 122.

[3] Side-Effects: Connect™ is an educational tool designed by Elizabeth Rankin. By class of drug, the tool assists professionals and patients understand the relationship between their prescribed medication and the symptoms they could present with for which they may or may not have been given a diagnosis or recognize their side-effects.

[4] The Patients’ Time Has Come outlines what’s needed and proposed to provide consent to treatment documents that are worthy of a signature at pages 133-141.

[5] Rankin, The Patients’ Time Has Come, 127.

[6] There are 13 outlined proposals included in the Consent For Permitted Treatment.