Informed consent is regarded in contemporary occidental societies as an established legal and ethical necessity for medical transactions. The concept has a long history and was outlined in the Declaration of Helsinki (1964) and the Nuremberg Code created in 1947 (Tam et al., 2015). Informed consent serves several objectives, namely to protect patients’ legal rights, ensure that medical practices are ethical, and preserve patients’ bodily autonomy (Hall et al., 2012). Nevertheless, the concept’s understanding and incorporation in practice can vary significantly among medical professionals – Allen v. Harrison serves as an example of a case where views on the concept diverged.
The case is based on the damage to a patient’s health, which happened as a result of an ER physician’s prescription. After swallowing a small nail, the patient had to go to a hospital emergency room, where she was examined and ordered to perform an x-ray (Laurance, 2017). The prescription based on this examination recommended a diet rich with fiber so that the nail would pass naturally, a check-up visit, and return to the hospital in the case of the patient’s state worsening. The following day, the patient returned to the hospital due to prolonged vomiting and underwent urgent surgery to remove the nail (Laurance, 2017). Furthermore, several additional surgeries were needed to treat the complications associated with the perforated bowel (Laurance, 2017). The plaintiff presented these facts, which resulted in the case against the physician based on the claim of negligence and absence of informed consent.
The role of the concept in question in the course of the case was initially dismissed. The trial proceeded on the negligence allegation, stating that “the doctrine of informed consent does not even come into play unless surgical treatment is rendered resulting in injury” (Laurance, 2017, p. 566). Nevertheless, after appellation, the Oklahoma Supreme Court recognized the relevance of informed consent, ultimately confirming the patient’s allegations. Primarily, this decision was based on viewing informed consent as applicable to non-invasive treatment and recognizing patients’ right to be aware of alternative treatment methods. In Allen v. Harrison, the court’s reasoning was founded on the fact that the ER physician did not secure the patient’s understanding of risks associated with the chosen treatment and did not acknowledge other options.
In order to be valid, informed consent needs to contain several essential components. According to Hall et al. (2012), the next elements should be incorporated to establish informed consent, specifically “the diagnosis, the proposed treatment, the attendant risks and benefits of the treatment, alternative treatments and their risks and benefits, and the risks and benefits of declining treatment” (p. 534). Each of these components serves to warrant that a patient is sufficiently informed about their state of health and can make decisions concerning it with the necessary information. The acknowledgment of a treatment’s risks, benefits, and alternatives is crucial to preserve one’s bodily autonomy, concretely to govern one’s body without external influence, which can be expressed in the withholding of information. Therefore, the informed consent in Allen v. Harrison supposedly cannot be considered full without the lacking elements.
Respect for an individual’s right to make choices regarding their body is indispensable in health care. These choices necessitate adequate and complete information, which was one of the issues in the considered case. A medical professional’s negligence and omission of essential details apropos of their patient’s physical state can result not only in court cases but also lethal accidents. In this respect, a proper completion of the procedures linked to informed consent obtaining can function as a preventive measure.
References
Hall, D. E., Prochazka, A. V., & Fink, A. S. (2012). Informed consent for clinical treatment. Canadian Medical Association Journal, 184(5), 533–540.
Laurance, J. (2017). Letting something pass. American Journal of Orthodontics and Dentofacial Orthopedics, 152(4), 566–569.
Tam, N. T., Huy, N. T., Thoa, L. T. B., Long, N. P., Trang, N. T. H., Hirayama, K., & Karbwang, J. (2015). Participants’ understanding of informed consent in clinical trials over three decades: systematic review and meta-analysis. Bulletin of the World Health Organization, 93(3), 186–198.