 Tips to avoid trouble . . .
Of interest to all physicians This is the first in a series of articles based on the many years of experience of Medical Officers at the CMPA who communicate with members on a daily basis. The content is simple yet the issues arising from each may be complex. Read on to discover how you might reduce your risk of medico-legal difficulties. These tips are not intended as guidelines nor do they represent any standard of care. Here are the first three tips. Tip #1 Obtain truly “informed consent” Patients and those who represent them regularly express concern about not being informed about potential serious risks associated with any proposed medical therapy. Take the time necessary to discuss the proposed therapy with the patient so as to obtain a truly “informed consent.” It is important your patient learns of any material risks or special risks for that patient. As well, there should be discussion of the proposed therapy, any reasonable alternative treatments and the possible outcome with no therapy. Be aware of the potential for language or comprehension difficulties and obtain the appropriate assistance. Material Risk
The courts generally consider material risks as being those that a reasonable person, in the same circumstances, would want to know before consenting to an investigation or treatment. This would include complications that occur commonly, and also those complications that occur rarely but have significant consequences for that patient. Special Risk
A court may consider the patient’s physical or psychological makeup will make even an uncommon risk of a medical investigation or treatment special or more important for that patient. Remember, the consent form itself does not
constitute “informed consent.” The
explanation given by the physician and the
dialogue between physician and patient about
the proposed treatment is the For more detailed information on informed consent and the meaning of all of these terms, please refer to the Association’s Consent: A guide for Canadian physicians (Fourth edition) by Kenneth G. Evans, General Legal Counsel. Tip #2 Avoid subjective and disparaging comments relating to the care provided by colleagues and other health care professionals A single thoughtless comment often forms the basis for dissatisfaction and/or complaint by patients and their families, especially when the clinical outcome is poor or unexpected. Remember that some time in the future, you may have to stand by statements you’ve made. Prior to commenting on the care provided by others, consider if you know enough of the facts to be in a position to offer a view of whether the care was reasonable at the time. In most instances the other health-care provider should be the one discussing his/her care directly with the patient if there is concern about the care or outcome. Tip #3 When things go wrong, undertake appropriate discussions with your patient A patient requires knowledge, delivered in a caring manner, of the known facts and health implications of the harm resulting from the progression of a disease or from health-care delivery. When harm from health-care delivery — an adverse event — has occurred, disclosure to the patient should be undertaken in a timely fashion. It is important to be aware of any mandatory disclosure and reporting regulations or policies in your hospital/ institution/jurisdiction. After an unexpected outcome is recognized, it is best if discussion with the patient occurs as soon as is reasonably possible, rather than waiting for the patient or family to ask for explanations.
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DISCLAIMER: The information contained in this learning material is for general educational purposes only and is not intended to provide specific professional medical or legal advice, nor to constitute a "standard of care" for Canadian healthcare professionals. The use of CMPA learning resources is subject to the foregoing as well as the CMPA's Terms of Use.
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