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As a general rule, written informed consent forms, signed by a patient, are
essential in protecting doctors and hospitals.  Then, the patient cannot
very easily argue lack of consent, knowledge, etc.  Without it, how do you
prove you got a patient's consent?  Think about why these came about in
common use in the first place--trust just was not protective enough.
 
As for procedure-specific written consent, I think it is better than a
general consent form for procedures with unusually severe or unusual risk
factors, as with lumbar puncture and risk of paralysis, etc.  With a general
consent form that does not outline risks and benefits, you are still in the
position of proving someone explained this all to a patient and the patient
understood and consented.  These 3 factors are difficult to prove--remember,
a jury is on the patient's side most of the time.  If it were me, I would
have risks & benefits spelled out, plus a place for a patient to sign
showing s/he received a personal explanation of these from the doctor, who
also signs, along with a signature at the end, showing consent to the
procedure, etc.
 
These days, you might also wish to include something to check off showing
the person's primary language and that they were counseled in that language.
Have the interpreter sign the form, if someone translates for the doctor.
When something goes wrong, a Plaintiff's (patient's) attorney will challenge
any and all facets of a consent form to win the case.  Remember, it is not
necessary to show negligence, malpractice or any problem with the actual
medical care itself, or even an unforeseen risk that led to disability or
death--only that the person did not voluntarily agree to the procedure and
accept its risks and that there was disability or death from the procedure
(causation).
 
Angela Foehl, J.D., M.P.H.
CONSULT, INC.  Expert Witnesses & Medicolegal Consultants
Arlington, VA  703) 685-0035              fax 703) 271-0980
 
Online brochure:   http://www.inc.com/users/CONSULT.html
 
 
-----Original Message-----
From: Pediatric Emergency Medicine Discussion List
[mailto:[log in to unmask]]On Behalf Of Ronald I Paul
Sent: Thursday, July 15, 1999 3:29 PM
To: Multiple recipients of list PED-EM-L
Subject: Lumbar puncture consent
 
 
Our hospital's risk management department wants us to begin getting written
informed consent for lumbar punctures.  How many of you use a written
consent
form?  Or do you rely on a general consent for treatment for emergency
services and an oral explanation prior to the LP?  Do you have preprinted
"risks and benefits" on the form?  Does anyone know of cases where a written
informed consent actually helped protect the hospital or physician when a
complication occurred from an LP?    Thanks.
 
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message: info PED-EM-L
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For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
  http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html