АДАМ УНИВЕРСИТЕТИ

УНИВЕРСИТЕТ АДАМ
ADAM UNIVERSITY

ADAM UNIVERSITY
FACULTY OF MEDICINE

ANALYZE THE PROBLEMS OF

INFORMED CONSENT OF THE PATIENT
FOR MEDICAL CARE
(Abstract)

AliLAIBA AMJAD
hussnain

GM-05
Gm-01-20

ASKAROV U.Y
MEDICAL LAW

2025
 ABSTRACT
Informed consent is a fundamental ethical and legal principle in medical
care, requiring healthcare providers to educate pa7ents about the risks,
benefits, and alterna7ves of proposed procedures or interven7ons. This
process hinges on two core elements: comprehension, where pa7ents
must understand their diagnosis, prognosis, treatment op7ons, and
poten7al outcomes in an accessible manner, and free consent, ensuring
their decision is voluntary and free from coercion. The document
explores the ethical du7es of doctors, including respec7ng pa7ent
autonomy, confiden7ality, and the right to self-determina7on, while
addressing challenges such as cultural differences, power imbalances,
and the influence of physician values on decision-making. It outlines
recommended disclosures for obtaining valid consent, methods of
consent (verbal, wriEen, or non-verbal), and the importance of
documenta7on. The paper also examines excep7ons to full informed
consent, such as emergencies or lack of decision-making capacity, and
the concept of informed refusal, where pa7ents may decline treatment
based on personal or religious beliefs, provided it does not harm others.
Finally, it highlights the need for improved communica7on, cultural
competency, and health literacy-based strategies to enhance the
informed consent process, especially in evolving medical contexts like
pandemics, calling for further research and policy development to
safeguard pa7ent trust and autonomy.
Informed consent is the process in which a health care provider educates
a pa7ent about the risks, benefits, and alterna7ves of a given procedure
or interven7on.
The pa7ent must be competent to make a voluntary decision about
whether to undergo the procedure or interven7on. Ideally, aHer fully
comprehending the informa7on about the project, the
pa7ent/par7cipant gives full and conscious consent for
the physician/scien7st to con7nue with the procedure.
There are many ethical issues that are entwined with the informed
consent process.
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THE ETHICAL MEANING OF INFORMED CONSENT
The ethical concept of "informed consent" contains two major elements:
comprehension (or understanding) and free consent.
Both of these elements together cons7tute an important part of a
pa7ent's "self-determina7on" (the taking hold of her own life and ac7on,
determining the meaning and the possibility of what she undergoes as
well as what she does).

1. COMPREHENSION
Comprehension (as an element in informed consent) includes the
pa7ent's awareness and understanding of the situa7on and possibili7es.
It implies that it has been given adequate informa7on about its diagnosis,
prognosis, and alterna7ve treatment choices, including the op7on of no
treatment.
Moreover, this informa7on should be provided in language that is
understandable to the par7cular pa7ent, who may have linguis7c or
cogni7ve limita7ons.
Comprehension in this sense is necessary for freedom in consen7ng.

2. FREE CONSENT
Free consent is an inten7onal and voluntary choice that authorizes
someone else to act in certain ways.
In the context of medicine, it is an act by which an individual freely
authorizes a medical interven7on in her life, whether in the form of
treatment or par7cipa7on in research or medical educa7on.
Physicians should have insight into how their opinions may affect the way
in which informa7on is presented to pa7ents and, as a result, influence
the pa7ent's decision to accept or decline a therapy.
Different models of the physician-pa7ent rela7onship exist (paternalis7c
,informa7ve ,delibera7ve ,interpre7ve), and the degree to which a
physician would share his or her values and professional opinions with
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pa7ents varies o In many cases, the physician's personal and professional
values and clinical experiences do, to some degree, influence the
presenta7on and discussion of therapeu7c op7ons with pa7ents.

THE ETHICAL BASIS AND PURPOSE OF INFORMED

CONSENT
One of the important arguments for the ethical requirement of informed
consent is an argument from u7lity, or from the benefit that can come to
pa7ents when they ac7vely par7cipate in decisions about their own
medical care.
The involvement of pa7ents in such decisions is good for their health-not
only because it helps protect against treatment that pa7ents might
consider harmful, but also because it oHen contributes posi7vely to their
well-being.

BEFORE OBTAINING INFORMED CONSENT

The informa,on disclosed should include:

1. The condi,on/disorder/disease that the pa,ent is having/suffering
from
2. Necessity for further tes,ng 3. Natural course of the condi,on and
possible complica,ons
4. Consequences of non-treatment
5. Treatment op,ons available
6. Poten,al risks and benefits of treatment op,ons
7. Dura,on and approximate cost of treatment
8. Expected outcome
9. Follow-up required
Pa2ent should be given opportunity to ask ques2ons and clarify
all doubts.

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There must not be any kind of coercion.
• Consent must be voluntary and pa,ent should have the freedom
to revoke the consent.
• Consent given under fear of injury/ in,mida,on, misconcep,on or
misrepresenta,on of facts can be held invalid.

VALID CONSENT
In order for the pa7ent's consent to be valid, he must be considered
competent to make the decision at hand and his consent must be
voluntary.
It is easy for coercive situa,ons to arise in medicine.
Pa,ents oTen feel powerless and vulnerable.
To encourage voluntariness, the physician can make clear to the pa7ent
that he is par7cipa7ng in a decision-making process, not merely signing
a form.
With this understanding, the informed consent process should be seen
as an invita7on for the pa7ent to par7cipate in health care decisions.

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HOW CONSENT IS GIVEN
verbally for example, a person saying they're happy to have an X-ray in
wri2ng for example, signing a consent form for surgery
Someone could also give non-verbal consent, as long as they understand
the treatment or examina7on about to take place - for example, holding
out an arm for a blood test .
This could be a:
nurse arranging a blood test GP
prescribing new medica,on
surgeon planning an opera,on
If someone's going to have a major procedure, such as an opera7on, their
consent should be secured well in advance so they have plenty of 7me to
understand the procedure and ask ques7ons

DOCUMENTATION
It is important to document the process of consent taking. It should be
prepared in duplicate and a copy handed over to the pa7ent. It should be

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dated and signed by the pa7ent or guardian, the doctor and an
independent witness.
Assis7ng nurse preferably should not be a witness.
Like all other medical records, it should be preserved for at least 3 years.

INFORMED REFUSAL
Pa7ent has got the right of self-determina7on. o If, a doctor diagnoses
varicella in a child, the parent may choose to avail no treatment because
of religious belief.
Doctor's duty is to explain the possible consequences of non- treatment
and benefits of treatment and leave the decision to the parent.
Such informed refusals must be documented clearly.
But, a pa7ent's freedom cannot impinge on the rights of others or cause
harm to a third party or community.
Therefore, the said parent's freedom of choice cannot extend to sending
the child to school, as the infec7on can spread to other children.
Discharge against medical advice also falls into this category and needs
to be properly recorded in the case sheet with signature of the
pa7ent/guardian.
In an emergency situa7on, for example intes7nal perfora7on, a doctor
may have to operate even in the absence of consent, to save the life of
the pa7ent.
It is possible that even with such an interven7on, the pa7ent may not
survive.
Assuming that the doctor is competent and has exercised due care and
diligence, doctor cannot be held responsible for pa7ent's death, as he
has acted in good faith and in the best interest of the pa7ent

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EXCEPTIONS TO FULL INFORMED CONSENT
ARE:
If the pa7ent does not have decision-making capacity, such as a person
with demen7a, in which case a proxy, or surrogate decision-maker, must
be found.
A lack of decision-making capacity with inadequate 7me to find an
appropriate proxy without harming the pa7ent, such as a lifethreatening
emergency where the pa7ent is not conscious When the pa7ent has
waived consent.
When a competent pa7ent designates a trusted loved-one to make
treatment decisions for him or her.
In some cultures, family members make treatment decisions on behalf of
their loved-ones. Provided the pa7ent consents to this arrangement and
is assured that any ques7ons about his/her medical care will be
answered, the physician may seek consent from a family member instead
of the pa7ent.

CONCLUSION
These problems underscore the need for improved communica7on,
cultural competency, and ethical prac7ces to ensure informed consent
protects pa7ent autonomy. Strategies include health literacy-based
forms, pre-consulta7on sessions, and culturally tailored materials.
Further research and policy development are essen7al to address these
challenges, par7cularly in evolving medical contexts like pandemics,
ensuring trust and safety in healthcare delivery.
Reference: hEps://www.ncbi.nlm.nih.gov/books/NBK430827/
hEps://trialsjournal.biomedcentral.com/ar7cles/10.1186/s13063-
02004969-w
(hEps://code-medical-ethics.ama-assn.org/ethics-
opinions/informedconsent)
(hEps://www.ncbi.nlm.nih.gov/pmc/ar7cles/PMC7079202/)
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(hEps://www.ncbi.nlm.nih.gov/pmc/ar7cles/PMC2078548/)
(hEps://pubmed.ncbi.nlm.nih.gov/20209388/)

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