Informed consent: Legalities, perspectives of physicians and patients, and practices in OECD/non-OECD countries

Informed consent: Legalities, perspectives of physicians and patients, and practices in OECD/non-OECD countries
Original Article
Amrita Shenoy, Gopinath N. Shenoy, Gayatri G. Shenoy
Médecine Palliative, 30 October 2021
In the medico-legal context, obtaining informed consent is described as the process in which the doctor apraises the patient of the intricacies of the proposed treatment, its alternatives, benefits and risks presented, therein, the right to refuse or withdraw consent at any point, and the risks of not undergoing treatment at all. As segments of disciplined inquiry, we, hereby, present a synthesis of the legalities, perspectives of physicians and patients, and practices in two cohorts of countries. We, specifically, analyze the above segments in the context of formative informed consent codes prevalent in France, United States, United Kingdom, Brazil, and India. In this process, we place focus on landmark judgments that conceived the frameworks of informed consent to its present stage. The present study, additionally, elaborates on the past practice of modulating the volume/intensity of medical details conveyed to the patient or, in other words, how informed the informed consent should be. We illustrate the above concept with an example of the once conservative English medical approach that has now shifted to a collaborative American one. An eminent Scottish judgment ruled in 2017 was instrumental in enacting the same. Conclusively, we explore how illiterate or semi-literate, financially constrained patients are withdrawn and passive in medical decision-making. The process of obtaining informed consent from the above stratum of poverty-stricken fiscally restrained patients is known to be potentially cumbersome. In this context, we, nevertheless, propose to expand on the ways of obtaining informed consent contextual to the above patient qualities.

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