Hospitals' Rules Regarding Signed Consent for Medical Procedures

At least some hospitals and doctors feel they have the latitude to decide when the patient is able to make their own medical decisions and when they are not. For example, if you are unconscious, your health care proxy gets to make the decision. That is simple enough. But what if you are sooo drugged up that you do not understand what they have just explained to you? That is where the doctor gets to make the call depending on his personal ethics or lack thereof. Doctors are given the authority to decide if a person is competent to make their own medical decisions. I have personally known of cases where doctors drug a person and then hand them a consent form not long after that while the drugs were definitely still in that person's system. They call this 'consent' when it works in their favor.

In my case, the doctors chose to explain the medical risks of the lumbar puncture to my 25 year old daughter, without anyone there but her, yet knowing that I was right outside the door and that I stood a far better chance of understanding what they were explaining. After all, she was still under the effects of Ativan... a drug categorized as a 'hypnotic sedative'. Yes, hypnotic... as in a very suggestible state. I was not even told that they were going to do the lumbar puncture until the nurse came in to tell me while they were in the middle of doing it. When the doctor came to speak to me about the results afterwards, she told me they explained everything that it included to my daughter before they did the procedure. I then asked this doctor if my daughter understood what they told her, knowing full well the answer ahead of time. The doctor grew uncomfortable at my question. She hemmed and hawed and mumbled something, and it was definitely not 'yes'.

Health care proxies do not mean a thing if the patient is still conscious and the doctors decide that the patient is able to make their own healthcare decisions. That is fine. I want my children to make their own INFORMED healthcare decisions. But I want to be able to give my input as a person who has the intellect and wisdom to critically evaluate what they are suggesting. I also want my children to understand all of the risks while they are coherent, just as I want to be coherent when I make my own healthcare decisions. I think that would be a given for most of us.

This could just as easily be your loved ones. If your child is of legal age, but perhaps barely over legal age, it is very possible he or she has not reached the stage in their life where they are assertive in asking questions and taking control of their own health care. That is what we as parents do. But if your child is 18 years old and is in the hospital, they are legally able to make their own medical decisions regardless of what drugs they have in their system, altering their awareness. When you have a combination of youth that tends to preclude you from questioning authority and you have doctors handing you a pen to sign a consent form while you stare uncomprehendingly at them, you are simply a pawn of the medical system. You may technically have a signed consent form, but it does not matter what they say, you (the patient) in all likelihood had no concept of what you were signing. However, the doctors seem to feel they have performed due diligence and given you all the risks. Isn't that the equivalent of the pharmaceutical commercials telling you what you need and then reading the potential side effects really fast (or giving those side effects in tiny print)? Why do they not want us to be aware of what we are signing up for? Could it be that they are more concerned with profits than our informed consent?

What if this were even your husband or wife? You could know their beliefs really well and know what their wishes would be, but your voice of reason could be excluded in favor of essentially the doctor's decision because your spouse has no idea what was just said to them. That is legal under the current structure of things. This has the potential to affect each and every one of us!!! Do you really want the doctors essentially making all of your decisions, or do you want it to be you or at least someone who understands your wishes far better than some man who sees you a couple of times a year... or even one who has never met you before? Can you trust your doctor to decide what is truly best for you? In an ideal world that would be the case. However, we do not live in an ideal world.