Informed Consent

Before any abortion at AMAC, the doctor obtains informed consent.  This means that the woman understands the procedure and accepts the risks and possible complications of both the abortion and any sedation or anaesthetic.

Patients are as fully informed as practicably possible about the abortion procedure, possible consequences and alternatives, before written consent is gained, and before any examination or treatment starts.

Advice given to a patient is noted and may be passed on to the referring doctor.

Duty to Inform

The purpose of the disclosure of information is to allow the patient to make an informed decision about the nature of the treatment, its degree of invasiveness, and the likely benefits and risks. The amount of information provided depends on the judgement of the doctor and nurse as to what is relevant for that particular patient.

Information covers all aspects significant to the patient making a properly informed decision. All material risks are made known to the patient. Reasonable and easily understood literature and information regarding the treatment is provided wherever possible, in addition to verbal communication and the opportunity for discussion.

When the patient’s first language is not English, it is the responsibility of the doctor to satisfy him/herself that adequate understanding has been achieved for consent to be given to the procedure or treatment to be undertaken, taking into consideration the complexity of the issues and the patient’s proficiency in English. An interpreter may be required.

The minimum of information provided to the normally competent patient includes, but is not be limited to:

• The nature of the treatment, including investigations
• The effect of the treatment, including side effects
• Other treatment options
• The likely short and long term outcomes
• The risk of the treatment, particularly those which are potentially serious and which may influence the patient’s decision regarding treatment
• The timeframe of treatment and recovery
• The name of the doctor providing the treatment
• The level of training of staff involved in the treatment
• The cost of the treatment
• The consequences of not undergoing any advised treatment
• Other information that the patient requests.

Duty of care

• There is joint decision-making
• Doctors and nurses take positive steps to encourage their patients to raise questions and concerns, in order to gain consent and satisfy the duty to inform
• The doctor and nurse ensure that the patient understands what is being proposed and that the information provided is accurate and relevant to that patient.

Obtaining Consent

Where there is intellectual disability, the doctor and nurse must ascertain whether or not consent and the duty to inform can be satisfied. If these conditions cannot be met, the consent of a guardian, person who holds the power of attorney and sometimes a court may have to be obtained before the examination or treatment can proceed. Where there is doubt regarding competence a second opinion is sought. A patient who is not legally competent cannot give a valid consent.

Women of any age are able to consent to the abortion procedure and may likewise refuse treatment, providing they understand the implications of the refusal.

The doctor and nurse whenever possible seek the consent of a parent or guardian where any major intervention (not covered within the CS&A act) is proposed and in difficult cases obtain a second opinion.

In the case of unconscious patients and in emergency situations when urgent treatment is needed to save life or avoid serious harm, it is recognised that full information cannot be given, nor consent gained. Where possible relatives are consulted, but the doctor and nurse must act always in the best interests of the patient.

If a patient does not wish to be fully informed about the proposed treatment, it is the doctor’s duty to explain at least in broad terms the nature of the procedure, the alternatives, the likelihood of a satisfactory outcome and the more serious and common side effects or complications. Information is withheld only in very limited situations such as when the doctor or nurse believes that the patient’s physical or mental health may be seriously harmed by the information.

Reference:

Guidelines for informed consent from Royal Australian & New Zealand College of Obstetricians & Gynaecologist.