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Informed explicit consent is the foundation of the ethical practice of medicine. Transmitting relevant information about procedures and gaining permission are aligned with one of the basic moral principles in health care: a patient’s autonomy. It is argued that every individual deserves to be respected and to retain their dignity even in the most vulnerable state. Patients are capable of governing the course of their action, and their healthcare provider is to aid them in making the most beneficial health decisions.
On top of that, medical facilities avoid malpractice lawsuits if each intervention is properly mediated. Informed consent facilitates work processes and serves the purpose of a systems-level check. However, numerous obstacles may manifest themselves that compromise a patient’s ability to make informed decisions. This paper discusses the issue of informed consent in patients with limited English proficiency in the radiology field.
Relevancy for the Radiology Field
The issue of informed consent is particularly relevant for the radiology field. For years, researchers and medical practitioners have been debating if patients should receive exhaustive information about all the possible risks of diagnostic procedures. For instance, computed tomography and radiography are associated with low- and medium-level radiation. It is especially crucial to inform pregnant women about consequences since radiography of the abdomen, pelvic area, and lumbar spine are linked to risks of childhood cancer and small head size in newborns (Chaparian & Aghabagheri, 2013).
Radiology patients constitute one of the groups of people susceptible to radiation-induced cancer risks on par with those who are exposed to radiation at work and in their living environment (Baheti, Thakur, & Jankharia, 2017). Even though the human body is capable of fixing radiation-induced damage, misrepair may lead to such adverse outcomes as chromosome dislocations and point mutations that increase the likelihood of cancer.
Informed Consent in Patients with Limited English Proficiency
The question arises as to how a medical practitioner can adequately communicate the specifics of radiographic procedures and possible adverse implications to a patient, especially if he or she is not exactly proficient in English. What certainly complicates the situation is that doctors are usually pressed for time and could not provide an oral comprehensive, detailed explanation to each patient even if they wanted to do so. This task is often delegated to nurses or technicians, which may be somewhat questionable from a medicolegal standpoint (Baheti, Thakur, & Jankharia, 2017). Nurses and technicians may not possess sufficient knowledge to answer all questions, and the odds that they speak a patient’s native language are rather low.
To avoid legal issues and help a patient make a decision, some measures may be undertaken. For instance, a patient information sheet in different language versions may be of good use and allow an individual to share relevant details about their medical history and learn about the procedures. However, even after filling in the questionnaire, patients may still have some questions. In this case, a medical facility may consider using a professional interpreter’s service or seek help from a patient’s family in case some members are more proficient in English.
In general, consent in health care is about a patient having access to relevant information and making health decisions based on presented data and previous health history. Tackling the issue of gaining informed consent is especially essential in the field of radiology. Radiographic diagnostic procedures involve exposure to low doses of radiation, and such exposure is associated with increased cancer risks. In some cases, undergoing the said procedures is necessary, and a patient should realize their implications. It is evident that obtaining consent personally is time-consuming whereas delegating the task to specialists with lower qualifications might present a certain risk from a legal standpoint.
The situation may be extraordinarily complicated if English is not a patient’s mother tongue, and their command of the language is limited. A medical facility should seek alternative ways of communicating information to such patients which may include patient information sheets or interpreting services.
Baheti, A. D., Thakur, M. H., & Jankharia, B. (2017). Informed consent in diagnostic radiology practice: Where do we stand? The Indian Journal of Radiology & Imaging, 27(4), 517-520.
Chaparian, A., & Aghabagheri, M. (2013). Fetal radiation doses and subsequent risks from X-ray examinations: Should we be concerned? Iranian Journal of Reproductive Medicine, 11(11), 899-904.