Informed Consent - What is Informed Consent? Why is it
Edith B. Wonnell, CNM, MS
Consent means to give approval for what is done to you, the patient, by another person, the provider. In form, consent implies education and clarification so both parties have a good understanding of the procedure, its risks and benefits and any alternatives for meeting the same need. The patient is the one who either gives or refuses their consent for any given procedure. Giving one's consent requires education on the part of the patient. Everyone must take responsibility for his or her own well being, especially in today's health care market. All too often, hospital informed consents are signed in labor when women are in no condition, mentally or physically, to understand what they are signing. At our birth center, the informed consent papers were included in the family handbook, which every family received on admission. At the early pregnancy class when most patients were still in the first trimester of pregnancy, the nurse midwife would spend about 30 to 60 minutes reviewing the consent forms. Patients were encouraged to study the forms at home and discuss any questions with a nurse midwife on subsequent prenatal visits where they would eventually sign the form. Patients should never be intimidated or afraid to ask questions. Too often, I have seen patients sign consent without really investigating whether a certain procedure was necessary or learning if there were any alternatives from what was being suggested. Remember that medical opinion and standards of care are constantly evolving. What is involved today and considered to be essential treatment may be outdated tomorrow. Case in point is newborn jaundice. Only a few years ago, every newborn with a bilirubin level of 12 or greater was given phototherapy and mothers were encouraged to stop nursing. Today we know that full term newborns can handle newborn jaundice at much higher levels without therapy or interruption of the nursing process.