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Consent in Hematology
- Consent is a process by which a patient decides, in consultation with those responsible for his or her medical care, whether to agree to the medical interventions proposed.
- Types
- Expressed- Verbal or in writing
- Inferred- Ex: Holding out arm for BP measurement
- By law, any medical procedure conducted without valid consent amounts to an assault.
- Consent provides reciprocal protection to the doctor from the patient, his relative or the state, who may seek to litigate.
- As autonomous individuals, patients have fundamental legal and ethical right to determine what happens to their own body.
- Obtaining valid consent prior to procedure or chemotherapy is absolutely essential.
- During consent patients must be informed about
- All aspects of treatment including aims and possible complications
- Expected response rates
- Alternatives to proposed treatment
- Anticipated duration of therapy
- Need of blood products
- Freedom to withdraw from consent anytime.
- Document patient’s consent in a consent form
- Even if signature is present, consent is not valid if patient is given too little information or biased information.
- Consent for treatment can be withdrawn anytime.
- If regimen includes several cycles, it is acceptable to have one consent form which specifies the number of cycles.
- Information sheets can be produced for each individual protocol along with a description of patient’s hematological disorder.
- Before concluding the consultation, the doctor should ask “is there anything else you would like to know?”
- Ideally patient must be given 24hours between consent and start of treatment, if it is clinically feasible.
- It must be born in mind that, an individual who has just received a diagnosis of cancer will have many anxieties, which may impede their ability to make an informed decision regarding treatment rapidly.
- If after discussion, patient refuses all treatments, this fact should be clearly documented in the notes.
- If patient is unable to give consent, treat the patient in accordance with “best interests”, which is not the same as best medical interests. It must take into account person’s past and present feelings, values and beliefs.
- Parental consent can be relied on when a child lacks the capacity to consent.
- Information must be provided in the vernacular language.
- The consultant initiating the treatment is ultimately responsible for ensuring that the patient has given valid consent.
- “Extended” consent must be taken for an extended intervention which was not a part of prior plan/ consent.
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