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Communication: a person-centred approach
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
Nurses must ensure that they gain consent before any care or treatment is given (NMC 2018c). The Code states that the nurse/nurse associate must ‘make sure that you get properly informed consent and document it before carrying out any action’ (NMC 2018c, p. 7). Seeking consent is a common courtesy, but people also have a legal and ethical right to determine what happens to them within healthcare settings, so consent, as stated above, is needed before any action is taken with the individual – for example, administering an injection or helping with personal hygiene. Informed consent is an ongoing agreement by a person to receive treatment, undergo procedures or participate in research, after risks, benefits and alternatives have been adequately explained to them. Key features of valid informed consent include being given: voluntarily and freely,without pressure or undue influence,by an appropriately informed person who has the capacity to consent to the intervention in question.
Communication skills
Published in Michael Parker, Charlie James, Fundamentals for Cosmetic Practice, 2022
Informed consent is both an ethical and legal obligation should you intend to perform any procedure on a patient. In 2015, the Montgomery Ruling in 2015 has superseded the Bolam test as the benchmark case in the United Kingdom for medical negligence regarding consent. The ruling applies to healthcare providers to ensure that they “take reasonable care to ensure that the patient is aware of any material risks involved in any treatment, and of any reasonable alternative or variant treatments”. A material risk is one in which “a reasonable person in the patient’s position would be likely to attach significance to the risk, or the doctor is or should reasonably be aware that the particular patient would be likely to attach significance to it”.
Classical nail surgery and removal of the proximal nail fold
Published in Robert Baran, Dimitris Rigopoulos, Chander Grover, Eckart Haneke, Nail Therapies, 2021
Patients should be aware of what will happen during and after surgery; thus, informed consent is a must. The digit to be operated should be scrubbed with a disinfective soap morning and evening starting 2 days prior to surgery. Smoking is to be interdicted, particularly on the day of operation. For toenail surgery, the patient is informed to bring an open shoe or sandal. Perioperative antibiotic prophylaxis may be discussed in case of delicate surgery and impossibility to completely sterilize the surgical field, particularly in case of bone surgery of the distal phalanx. The individual pain threshold is discussed in order to be able to adjust postoperative analgesics (Richert et al. 2011; Haneke 2017; Richert et al. 2019).
More-Than-Partial Entrustment in Pragmatic Clinical Trials
Published in The American Journal of Bioethics, 2023
The partial-entrustment model (PEM) addresses the issue of medical-research teams’ ancillary-care obligations (Richardson 2023)—their obligations to address medical needs their participants have, but that need not be addressed to execute the study safely and soundly or to satisfy any promises made in recruiting participants. The model has two components. The first is the duty, applicable to all persons, to rescue people from danger when doing so is not significantly onerous. This sets a baseline level of care that researchers owe to the participants. The model’s name, however, comes from the second component, which argues that by accepting the participants’ permission to touch and probe them or collect samples, images, or information about their bodies in ways required by the study protocol, the research teams have undertaken special but partial responsibilities regarding their participants’ health. In giving these special permissions, the participants have waived their rights not to have their bodies touched, probed, and examined in these ways without their consent. By requesting and accepting these permissions, I have argued (Richardson 2012, chap. 3), the research team takes on special moral responsibilities to follow up on participants’ problems they become aware of when acting on those permissions. In the context of traditional explanatory research, this entrustment of responsibility is partial because it applies only to medical issues that the research team discovers by carrying out the protocol’s procedures, which are set out in the informed-consent process.
Evaluating first year residents’ communication skills: a health literacy curriculum needs assessment
Published in Journal of Communication in Healthcare, 2023
Zach Budesa, Melinda Klar, Sujata Datta, Emily Moore, Leonard Lamsen
One aspect of communication with which residents struggle is obtaining informed consent 20. Informed consent is a process that ensures patients agree to medical treatment with full knowledge of the procedure, including risks, benefits, and alternatives. Obtaining thorough informed consent reduces costly medical errors and unwanted outcomes 21. Physicians who do not accommodate patients’ levels of health literacy may not impart the key information patients need to provide a truly informed consent 4,22. Patients who do not understand the procedure they are agreeing to may experience danger23 and have less accurate expectations about the results of procedures 24,25. When providers do not communicate effectively, they may open themselves to ethical and legal liabilities26. Physicians must have skill in describing treatments, explaining risks, and discussing alternatives without using jargon that is confusing for patients.
Epidemiology, pathogenesis, clinical presentations, diagnosis and treatment of COVID-19: a review of current evidence
Published in Expert Review of Clinical Pharmacology, 2021
Sayeeda Rahman, Maria Teresa Villagomez Montero, Kherie Rowe, Rita Kirton, Frank Kunik
In addition, informed consent is not required in the case of an emergency, such as in the case of a life-saving procedure for a patient diagnosed with COVID-19. Another example of an exception to obtaining informed consent is when the COVID-19 patient waived his or her right receiving information related to COVID-19 [254]. If a physician has to treat a patient diagnosed with COVID-19 who is incapacitated because he or she is either psychotic, unconscious, suicidal/homicidal, or under the influence, obtaining informed consent is not necessary [257]. Furthermore, physicians can invoke therapeutic privilege if physicians agree that the COVID-19 patient is unable to make good decisions for himself or herself. In this case, beneficence trumps the adult patient’s autonomy; hence, informed consent is not required during treatment [255].