12/06/2019
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As a medical student I had at most, an hour of training on obtaining informed consent and only for medical procedures - not medication use. That consisted of making sure you read a patient the risks of a procedure and had them sign the form confirming this. It did not include actually explaining the risks - just reading a list of them to someone who was feeling unwell and vulnerable, but at the same time, influencing them by telling them how much they need the procedure. The implications of the risks tended to be minimized, rather than personalized - as in this is what this could really mean for you if this horrible thing happens. No breadth of alternatives were given.
In the clinic, pharmaceuticals, invasive tests, and procedures were usually afforded much less informed consent time - if any. Usually a prescription is just written, it's assumed the patient will take it, and no risks are communicated.
Comments like "I'm just going to do a little snip because I don't like your baby's heartbeat" (l heard that one not too long ago; I stopped the OB from doing it; baby was born 30 seconds later, no problems), the vaginal exam someone went to do without even waking a sleeping mother (that person got stopped in their tracks, too!); the medication put in the IV without the patient being told....ALL NOT OKAY.
EVERY exam, EVERY procedure, EVERY medication REQUIRES your INFORMED consent (unless a dire emergency or you're medically unable to give consent, like you're unconscious, or delirious and it's a lifesaving intervention). That means you get to ask questions until you understand AND you can SAY NO. Or I'd like to think about that. Consent doesn't just mean someone reads a list of possible risks or tells you it's needed. It's a full explanation of RISKS and ALTERNATIVES. AND what happens if you say no or wait.
Yet this is not happening!Let's take hysterectomy, for example: AT LEAST 20% are considered medically entirely unnecessary, and only 30% of women advised to have a hysterectomy, of a study of over 5,000 women, were informed of non-surgical alternatives by their doctor. Women in their 30s were the least likely to be informed!