Informed consent process needs reform

It's time to revise the informed consent process and create a reasonable-patient standard through shared decision-making between physicians and patients, according to a viewpoint piece in the Journal of the American Medical Association.

Healthcare needs to work to create a high-value, patient-centered process for informed consent, write Erica S. Spatz, M.D, of the Yale University School of Medicine, Harlan M. Krumholz, M.D., of the Center for Outcomes Research and Evaluation at Yale-New Haven Hospital, and Benjamin W. Moulton, of the Informed Medical Decisions Foundation.

Washington is the only state in the country that currently recognizes shared decision-making as an alternative to the traditional informed consent process, according to the authors. Too often, they say, informed consent discussions lack the details that are needed for meaningful patient decision-making, documents are not easy for patients to understand and paperwork is signed minutes before the start of a procedure when patients are least likely to ask questions.

Instead, laws should promote a process that truly supports a reasonable-patient standard through shared decision-making, the authors argue. They point to a 2012 review of 115 studies that involved more than 33,000 patients. Those who engaged in shared decision-making and received some sort of a decision aid with information about different options for treatment, they write, "had greater knowledge of the evidence, felt more clear about what mattered to them, had more accurate expectations about the risks and benefits, and participated more in the decision-making process."

To learn more:
- read the commentary