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Informed consent at the heart of most medical procedures

By Staff

The threshold for obtaining a patient’s informed consent varies depending on the nature of the medical procedure performed, says Toronto orthopedic spine and trauma surgeon Dr. Michael Ford.

Ford is often called on by both plaintiffs and defendants to give his expert opinion in instances of alleged medical malpractice, and he says the issue of informed consent is often at the heart of the matter.

In general, medical professionals cannot legally carry out procedures without first receiving consent, but Ford tells that it is typically only in dispute during malpractice cases when the procedure is elective.

“If you have a true emergency, then the issue of consent is usually moot because when you’re trying to save a life, the expected benefits of surgery far exceed any potential risks,” he says. “But, when the surgery is elective, and nobody is going to die if it doesn’t happen, then a detailed explanation of the risks and benefits plays a huge role in the decision-making process.”

Just as medical professionals are not held responsible for every complication resulting in an adverse surgical outcome, Ford says they cannot be expected to cover every single possibility in order to meet the standard of care expected of them when obtaining informed consent.

“It has to be within reason. It’s not necessary for the physician to have a three-hour conversation going into detail about every single potential risk, because it’s not realistic,” he says. “There are some one-in-a-million complications that can happen during surgery, but the question is whether the individual would have proceeded anyway, even if they had known about that risk.”

Ford says a physician’s focus should be on informing patients of the most common risks associated with a particular procedure, as well as the most potentially catastrophic.

“If you’re operating near the spinal cord, you have to talk about the risk that something could go wrong,” he says. “Even though it’s very rare for something to happen, the effect it could have on a person’s life in those cases is huge.”

As well as disclosing the known material risks associated with a particular treatment, health-care professionals must also take into consideration the circumstances of the specific patient before them, Ford adds.

In the event a complication does occur, he says the value of a comprehensive and reasonable pre-surgical discussion about informed consent is heightened.

“If you’ve discussed the risks beforehand, then animosity between the caregiver and the patient is less likely to develop or get out of hand,” Ford says. “If patients know the risks, it’s easier for them to understand what happened and turn their attention to moving forward.”

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