The purpose of this assignment is to discuss issues and considerations associated with patient consent and confidentiality. The seeking of informed consent is an essential precursor to medical intervention, being at the core of the collaborative relationship between the patient and the health care professional (Freegard, 2006) and contributing to the overall duty of care. This essay will describe the basic elements of informed consent and broach some of the associated ethical considerations. The rights of a patient to maintain privacy and control over release of personal information will also be explored along with applicable points of law associated with patient confidentiality and privacy in general. Central to these issues is the concept of patient autonomy, the patient’s rights to make free and personal decisions about their treatment and general care (Kerridge, Lowe & Stewart, 2009). This discussion paper will explore the ethics behind the requirement for patient autonomy and consider the possibility that exceptions might exist to the necessity to gain consent and maintain confidentiality. It is generally accepted in health care that there are four elements of informed consent. The first of these involves the disclosure of all relevant information to the patient. Importantly, information needs to be passed both ways between the patient and health care professional/s (Godbold, 2010). The patient needs to be advised on the nature of the issue being dealt with, the expectation of resolution, suggested courses of treatment along with the risks involved and the accuracy of the information being provided (Macdonald & Magill-Cuerden, 2011). The carer must also receive information from the patient, seeking to learn of pertinent issues around the status of the patient’s health. It is also important to gather cultural and emotional information which may affect the validity of any consent provided. The amount of information required or given may be aligned to the nature of the intervention and the risk of harm presented by the progression of treatment (Freegard, 2006). Secondly, ensuring that there is an appropriate level of understanding is key to the provision of informed consent. It is not satisfactory to progress a course of treatment on consent which may have been given without the patient having sufficient understanding of the reasons for or the implications of the treatment being provided. A patient’s comprehension of the information can be enhanced through taking care in the way it is delivered (RANZCOG, 2006). Health care professionals are encouraged to minimise the use of medical jargon where achievable so that the patient is more likely to fully understand the implications of the presenting condition and options for intervention (Macdonald et al, 2011). The level of understanding can also be impacted by when the information is given. In midwifery practice, great importance is placed on receiving and gaining understanding of information antenatally, as there may be decreased opportunity to understand information about treatments and conditions during childbirth (Godbold, 2010). Another feature of informed consent is that the patient should be competent to make an informed decision about their health care. Competence in this sense involves an awareness of the personal right to make choices whilst recognising consequences (Jonas, 2007). For a patient to make an informed choice, they must possess the ability to reconcile the information given, comprehend it’s relativity to their circumstance and establish reason to act. Additionally, the patient needs to be able to communicate this reasoning and decision to the health care professional (Freegard, 2006). The competency of a patient may be difficult to establish, particularly in the young and the aged. Expectations can vary between countries and it is interesting to note that a 12 year old child may be considered competent in the British health system (Alderson, 2007). The...
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Alderson, P. (2007). Competent children? Minors’ consent to health care treatment and research. Social Science & Medicine Journal, 65.11, 2272-2283. Retrieved from ScienceDirect.
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