U.S. History of Patient Consent. Free Essay

Patient consent is essential when it comes to the relationship between a physician and a patient. It is what the physician tells or withholds from the patient. The moral principle behind telling or not telling a patient what they ought to know is fundamental in medical practice. Patient consent in the United States dates back to the 5th century back in the era of Hippocrates. Research shows that for the last 30 to 40 years, it was evident that the sole responsibility of what information should and shouldn't be shared was on the physician (Arney and Lewin 950). During the 5th century, Hippocrates writers offered advice to patients, and the motive was deducing a measure that will best benefit the patient without considering the patient’s views.

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Previous oaths in the Hippocrates era were used only for the benefit of the patient. The thought behind it was that the patient would be harmed in a certain way if he or she knew what the physicians were doing. A clear picture of this practice is the description of Plato, who described two cases of patients one was a slave, and the other group was the "free men” (Malatesta 121). Slave patients described by Plato asked no questions, were given no information about their illnesses, and handed down medicines without any instructions. The “free men” however had different experiences as their treatment was more thorough, and it involved their input in treatment measures. It was evident that social class contributed to the disparity in medicine, and it made patients from lower social classes consent to what doctors prescribed. It was expected of patients to offer no resistance and agree implicitly about their cure.

Henri de Mondeville further suggested that information should be given to a patient considering their emotional stability. Similar comments in the works of other medical experts that suggested physicians should make essential decisions. The road to change slowly took a turn with other medical practitioners believing in the need to inform their patients about their treatment choices. Medical practitioners such as Benjamin Rush taught his students the importance of not opposing unnecessarily minor prescriptions for patients (Berg and Appelbaum 301).

Though Benjamin Rush was open to the idea of informing patients on decisions made for their treatment, he proposed the most important of decisions be left for determination by the attending physician. The physician’s decision was made based on his/her assessment of a patient's wellness. In the year 1847 when the first version of AMA code of medical ethics was published, there was a title "obligations of patients to their physicians" there was a part in the publication that openly limited the amount of information that could be divulged to patients as outlined by (Malatesta 115). The better part of the 19th century saw many medical professionals such as Oliver Wendell continue to emphasize on patients receiving little information and say on the decisions made by physicians. The doctor's decision to give or not give information depends majorly on the degree of illness. Famous professors of medicine such as Dr John Gregory have expressed the complexity of deciding for treatment and if the patient will benefit from the prescribed mode of therapy (Davey 556). It is therefore essential to note that in ancient America to physicians often made the decision not to inform their patients of certain information in good faith; the data would have caused more harm than good. Patients only shared data to coarse them into compliance.

The autonomy of physicians over a patient's decision-making continued for two millennia when the change came in the 19th century. It is crucial to examine articles such as the Journal for the medical association that gives examples of how to approach medical issues. The 19th century saw the emergence of change and discussions regarding the inclusion of patients in decision making a sign of respect and dignity for the patient. There was a definition of patient consent, as more doctors recognized the need to inform patients about their conditions regardless of their feelings and reaction.

As years went by physicians recognized and understood the need of a new moral basis upon which to make decisions, all these changes were occurring across all the aspects of medical practice including and not limited to legal issues. The judgment of physicians on legal aspects spelt out not informing a patient before deciding assault and battery. A historical decision that influenced forming of the informed patient decision was a case presided over by Cardoza in 1914 pitting a woman against a doctor for performing surgery without her consent. The ruling read in part that every human being of adult years and sound mind had a right to determine what goes to their bodies. The case of Salgo and Leland Stanford jr that was a landmark case saw the use of the phrase “informed consent” (Katz 221). The need for informed patient consent was recognized, and the patient's right to self-determination was introduced, allowing patients to participate in decision-making regarding their state of health. It allowed patients to decide for themselves what outcome is preferable in a change that is now known as informed consent in modern medical practice.

Informed consent in modern-day America allows patients to actively participate in their treatment and recovery process by choosing the best option of treatment available. The modern concept is, however, different from its predecessor because there is a moral compass followed by all medical practitioners. The principle defines what is beneficial for the client based on respect for the patient and their right to self-determination.

The ethics of practice for medical practitioners now include a clause involving the patient when there is a need to make minor or major medical decisions. Patient consent is now a mandatory procedure in making decisions about patient health. Hospitals nowadays incorporate informed patient consent when making a diagnosis by telling the patient the state of their health after evaluation and informing them about available treatment measures (Edelstein 51). Some patients suffer from terminal illnesses which have no cure though there is ongoing research on possible treatments. Experimental drugs are available for such patients, and the patients only receive the trials after being advised and given relevant information by the physician before the patient either agrees or declines the administration of the trial drug. Consent forms are available in hospitals where a patient signs the consent form and agrees to whatever medical procedure they have given their consent.

The decision-making process of client consent involves healthcare providers making decisions collectively in cases where there exists responsibly more than one treatment alternative. The process consists of factoring in the unique preferences of clients and needs. Consent is also applied in medical institutions when the patient is unable to make a decision. A close member of the family or a friend chosen by the patient gives their views to ensure the decision made by both parties has the best interests of the patient at heart (Fan 241). The case applies to children and patients who are too sick to respond to queries. Customer consent is also used in healthcare institutions when disseminating patient information. It allows physicians to determine the necessary information that will help deliver an informed diagnosis.

Blood transfusion and administration of anesthesia require patient consent because there are varying views on receiving blood from an unfamiliar person. Anesthesia can render a person immobile and unconscious; some patients prefer to be awake while performing minor surgeries and other treatments. In conclusion, obtaining informed consent should follow the correct procedure of describing proposed interventions, recognizing the patient’s role in decision-making, discussing alternatives, stating the risks, and asking for the patient’s preferences.

Works Cited

Arney, Jennifer, and Benjamin Lewin. "Models of physician-patient relationships in pharmaceutical direct-to-consumer advertising and consumer interviews." Qualitative health research 23.7 (2013): 937-950.

Berg, Jessica, and Paul Appelbaum. Informed consent: legal theory and clinical practice. Oxford; New York: Oxford University Press, 2001.

Davey, Lycurgus M. "The oath of Hippocrates: a historical review." Neurosurgery 49.3 (2001): 554-566.

Edelstein, Ludwig. The Hippocratic Oath: text, translation and interpretation. Ancient medicine: selected papers of Ludwig Edelstein (1943): 3-63.

Fan, Ruiping. Family-oriented informed consent: East Asian and American perspectives. Cham: Springer, 2015.

Katz, Jay. The silent world of doctor and patient. Baltimore: Johns Hopkins University Press, 2002.

Malatesta, Maria. Doctors and patients: history, representation, communication from Antiquity to the present. San Francisco, CA: University of California medical humanities press, cop. 2015.