School has started and the first week was full of very “un-scientific” lectures. Most of the lessons were on Ethics, Medicine and Society rather than Biochemistry, Anatomy, Physiology or whatsoever. I guess the lack of professionalism in junior doctors nowadays is one of the main reasons that emphasis has now been shifted on culturing the more humanitarian aspect of a doctor. Somebody must have finally come to the realization that the production of clinically efficient doctors voided of compassion and ill-disciplined by a lack of ethics is a major concern for the future of Singapore’s health sector.
Today, in Ethics, we talked about consent. The importance of acquiring consent from patients is due to the fact that a physician should first and foremost respect the autonomy of his patient. Failure to obtain consent goes against the fundamental right of a patient to have the freedom of choice. In such cases, the physician might subject the patient to unnecessary stress or social stigma should the patient test positive for HIV without prior consent being sought. Consent is therefore important here as it shows the mental preparedness of a patient towards the outcome of any medical procedures. Meanwhile, failure to obtain consent hand perpetuates the disrespect of the physician towards human dignity and bodily integrity. Secondly, from a clinical point of view, the consent of a patient to make an informed and voluntary decision to participate in a certain medical procedure indicates that the patient has faith in the surgeon’s abilities and shows confidence in recovering from a particular illness. This optimistic attitude could contribute to the placebo effect, thereby boosting the efficacy of a treatment tremendously. Lastly, from the point of view of the medical practitioner, it must be noted that patients have the right to decide whatever action that is appropriate to be performed on their bodies. Therefore, the doctor’s failure to obtain patient consent prior to any medical procedure could subject physicians to a criminal charge of battery or negligence.
The key components involved in informed consent again rests on the principle of patient autonomy. The three ethical components for valid consent involve one to be competent, informed and voluntary. Doctors are to disclose information which includes the broad terms of the nature of the procedure, the probabilities of any side-effects (even if the risk is almost negligible) and in certain cases the severity of the side effects. Any other possible treatments must also be brought up and an honest response to any questions from the patient must be given should the patient enquire relevant information about a medical procedure. On the other hand, the patient must be competent enough to understand the information provided by the doctor and make a voluntary decision out of his own will. He must not merely assent and submit to the doctor’s authoritative order but instead specifically authorizes the doctor to initiate the medical plan. In the process of an informed consent, the patient assumes the responsibility of decision making and then transfers that responsibility to the doctor for him to eventually make a decision regarding the medical procedure which is in the best interests of the patient.