Discuss about the Importance Of Valid Consent In Healthcare.
In healthcare, valid consent is an essential component where the healthcare provider discloses information to a patient who is competent enough to make voluntary choice in accepting or refusing treatment. It is the legal and ethical rights of a patient to know and direct what happens to their body However, there are various forms of barrier that is witnessed in getting a valid consent from the patient. In the given case study, Lalah Khalili, a 14-year-old girl is suspected with post-traumatic stress disorder and to give her a mild sedative, conduct and ECG and take a blood test, a valid informed consent is required. However, she is a minor and lack judgment power to make able decisions for her. In such cases, her parents have to provide a valid consent, but they have limited English ability. Therefore, the following essay deals with the discussion of importance of valid consent, barriers for the valid consent and solutions for getting the valid consent.
A person who has the capacity to make effective decisions about a specific issue gives valid consent and free from any influence or manipulation that might alter the decisions made as stated by Queensland Health, Australia (Queensland Health, 2013). When a transparent decision is made between the patient and healthcare professional, it offers balance and sensitivity to the situation. Information must be given to the patient or any reasonable person who can make reasonable valid consent in the patient’s position. Impaired informed consent leads to 11.5% of conciliated complaints and 3.4% of medical negligence in the valid consent process (Grady, 2015). Moreover, a person who is minor (below 18 years of age) is considered minor and requires parents or a legal guardian to provide valid consent on behalf of the child’s treatment. However, under the Australian Law, teenagers are recognized as competent to provide informed consent for themselves, as they get older. Parents and their minor children hold concurrent rights in providing consent for treatment for minor patients below the age of 18 years. There is various type of consent like implied, verbal and written form.
In the given case study, although Lalah Khalili has the ability to make decisions for herself, it should be taken under the vigilance of her parents. In healthcare, nurses have the responsibility to work within the law that shape their nursing practice. Under Registered Nurse Standards for Practice in Nursing and Midwifery Board of Australia (NMBA), valid consent is an ethical and legal obligation. Failure to obtain a valid consent is considered a criminal offence and tort of law (Cashin et al., 2017). They have the obligation to work under ethical frameworks when they make efficient decisions during assessment, planning, action and evaluation. In the given case study, before the administration of mild sedative, conduction of ECG and blood test, a valid informed consent is important to obtain. However, there are barriers witnessed in this situation that will be discussed in the next section.
A nurse should take care of the fact that the patient is providing her consent to the treatment procedures voluntarily and without any coercion feelings. She should be able to understand the intervention elements and make a necessary choice for receiving the intervention. However, one major issue that occurs in obtaining valid consent of minors in health intervention is the disruption of balance between the vulnerability and immaturity of the minor and the right to get emancipated from parent’s decisions. The physicians and nurses are not supposed to assume that a patient lacks the capacity of providing consent based on her behavior, age, appearance, disability, beliefs, literacy or socioeconomic status, or mental health condition (such as post traumatic stress disorder). Age influences, language barriers and mental stigma can hinder effective communication between the nurse and the patient while obtaining consent. The nurses should take care of the fact that valid consent will have to be provided to the patient, Lalah Khalili in a language that she and her parents can comprehend and understand. It is known that she and her brother are good English speakers. If the consent is provided to her in English language, the quality of interpretation of the consent will be correct. However, if there is the use of a language not known to her, it can lead to misunderstandings and incorrect responses. Furthermore, her parents should also be involved in the process of providing consent owing to her young age. If her parents are non-English speaking, poor translations from the staff can lead to dangerous misinterpretations and misdiagnosis (Lee et al., 2017). This will lead to decline in patient care quality and satisfaction. Another barrier is the age of the patient. Australian laws related to medical treatment recognize that patients aged 18 years or more have the legal capacity to make decisions related to self healthcare (Bismark et al., 2012). Prior to 18 years of age, the legal guardian or parents are entitled to provide consent to the medical treatment of their child. Minors are generally not allowed to give consent to own treatment, except when they are in the military or married. However, the law states that teenagers become competent with development and are at times capable to get involved in the process of obtaining the consent (Law Reform Commission, 2008).
Depending on the age and competency, minors can be approached for participation in giving valid consent. The nurses and physicians would have to judge the each patient based on their individual capacity. Moreover, the nurses will also have to evaluate whether the patient demonstrates sufficient knowledge of her health condition and a sound understanding of the necessary medical interventions that include the adverse effects that can occurs and the impending dangers that can arise if she withdraws from the treatment. Another barrier that can arise while obtaining consent is the patient’s medical condition (Spatz, E. S., Krumholz, H. M., & Moulton, B. W. 2016). She has been admitted after an episode of post traumatic stress disorder. This condition can arise as a result of some traumatic experience and is a form of anxiety disorder. Often patients suffering from PTSD witness some events that create an impact on their mental health. The concerned patient and her parents may not allow consent to therapeutic interventions due to fear of stigmatization from the mental condition, embarrassment issues and fear of less availability of specialist therapies. The altered mental state of the patient may make her incompetent to judge the process of intended medical treatment. This will create a hindrance in giving consent for interventions.
Nursing profession recognizes human rights universally and regards safeguarding patient dignity as a moral responsibility. According to the code of ethics for Australian nurses, they should value informed consent and decision making while catering to the needs of their patients. They should value the moral and legal right of all patients to participate in decision-making events related to their healthcare concerns (Nursing & Council, 2008). This involves avoiding any cultural stereotype based assumptions. They should use relevant illustrations and written information to depict the patient’s current physical condition and the possible route of therapeutic intervention. They should arrange for a qualified health interpreter to overcome language barriers prior to consultation (Douglas et al., 2012). A registered nurse who has undergone extensive training is eligible to take delegated consent. Nurses should also respect and recognize their patient’s wishes once the latter is fully informed and has the capability of take decisions. However, if the patient declines giving consent to any life-saving treatment methods, the nurse should immediately consult substitute decision makers and seek second opinion from medical practitioners.
When the patients are unable to provide consent owing to young age, disabilities or legal constraints, the nurses should recognize and efficiently utilize the contribution made by parents or legal guardians for providing effective treatment facilities. Nurses should be knowledgeable about these circumstances and should facilitate the role of partners, family members and friends in decision-making processes. Patients with limited literacy on health issues should be described the plan for medical treatment to fill in the gaps in their analysis of the current situation. The reason for ambivalence shown by the patient should be ascertained (Simonds, Garroutte & Buchwald, 2017). They should be given time to reflect on the suggestions provided and to reconsider their health status. The social and cultural history of the patient should also be considered in case it poses a hindrance in giving consent. Any form of stigmatizing attitudes associated with mental health status should be removed (WA Health, 2016). This can be done by creating awareness among the patient and the family members regarding the underlying causes of mental disturbances and the effective treatment procedures that can be adopted to reduce the symptoms. It is the legal and ethical obligation of a nurse to inform patients about the risks associated with noncompliance. They should also reassure their patients that the medical team will provide the best facilities to help the patient. Regardless of whether consent is obtained or not, nurses should document all details relevant to the proposed treatment (Hoeyer & Hogle, 2014). Well documented consent will verify that the nurse and physicians have met their obligations in providing necessary information to the concerned patient about possible treatment options.
From the above discussion, it can be witnessed that obtaining a valid consent is important in the healthcare and nursing practice. Healthcare professionals have to work in accordance with the law and ethics to provide the best quality of care and ensure patient safety. In the case study of Lalah Khalili, various barriers were observed while obtaining an informed consent like language, age and lack of health literacy. As she is a minor, her parents must be involved in obtaining the informed consent before the diagnosis and treatment process. Moreover, her parents have limited English ability and in such cases qualified medical interpreter is required who would provide accurate information to Lalah and her family that aid in taking able decisions for her PTSD treatment.
References
Bismark, M. M., Gogos, A. J., McCombe, D., Clark, R. B., Gruen, R. L., & Studdert, D. M. (2012). Legal disputes over informed consent for cosmetic procedures: a descriptive study of negligence claims and complaints in Australia. Journal of Plastic, Reconstructive & Aesthetic Surgery, 65(11), 1506-1512.
Cashin, A., Heartfield, M., Bryce, J., Devey, L., Buckley, T., Cox, D., … & Fisher, M. (2017). Standards for practice for registered nurses in Australia. Collegian, 24(3), 255-266.
Douglas, C., Rebeiro, G., Crisp, J., & Taylor, C. (2012). Potter & Perry’s fundamentals of nursing-Australian version. Elsevier Health Sciences APAC.
Grady, C. (2015). Enduring and emerging challenges of informed consent. New England Journal of Medicine, 372(9), 855-862.
Hoeyer, K., & Hogle, L. F. (2014). Informed consent: The politics of intent and practice in medical research ethics. Annual Review of Anthropology, 43, 347-362.
Law Reform Commission. (2008). Young People and Consent to Health Care. Law Reform Commission: Sydney. Retrieved from: https://www.lawreform.justice.nsw.gov.au/Documents/Publications/Reports/Report-119.pdf
Lee, J. S., Pérez-Stable, E. J., Gregorich, S. E., Crawford, M. H., Green, A., Livaudais-Toman, J., & Karliner, L. S. (2017). Increased access to professional interpreters in the hospital improves informed consent for patients with limited English proficiency. Journal of General Internal Medicine, 1-8.
Nursing, A., & Council, M. (2008). Codes of Professional Conduct & Ethics for Nurses & Midwives in Australia 2008. Nurses Board of South Australia.
Queensland Health. (2013). Delegated consent position statement. Retrieved from: https://www.health.qld.gov.au/__data/assets/pdf_file/0022/156082/delegated_consent_pos_sta.pdf
Simonds, V. W., Garroutte, E. M., & Buchwald, D. (2017). Health Literacy and Informed Consent Materials: Designed for Documentation, Not Comprehension of Health Research. Journal of Health Communication, 1-10.
Spatz, E. S., Krumholz, H. M., & Moulton, B. W. (2016). Informed Consent and the Reasonable-Patient Standard—Reply. Jama, 316(9), 993-994.
WA Health. (2016). Consent to Treatment Policy. Retrieved from: https://www.health.wa.gov.au/circularsnew/attachments/1135.pdf
Essay Writing Service Features
Our Experience
No matter how complex your assignment is, we can find the right professional for your specific task. Contact Essay is an essay writing company that hires only the smartest minds to help you with your projects. Our expertise allows us to provide students with high-quality academic writing, editing & proofreading services.
Free Features
Free revision policy
$10Free bibliography & reference
$8Free title page
$8Free formatting
$8How Our Essay Writing Service Works
First, you will need to complete an order form. It's not difficult but, in case there is anything you find not to be clear, you may always call us so that we can guide you through it. On the order form, you will need to include some basic information concerning your order: subject, topic, number of pages, etc. We also encourage our clients to upload any relevant information or sources that will help.
Complete the order form
Once we have all the information and instructions that we need, we select the most suitable writer for your assignment. While everything seems to be clear, the writer, who has complete knowledge of the subject, may need clarification from you. It is at that point that you would receive a call or email from us.
Writer’s assignment
As soon as the writer has finished, it will be delivered both to the website and to your email address so that you will not miss it. If your deadline is close at hand, we will place a call to you to make sure that you receive the paper on time.
Completing the order and download