What is Informed Consent? Let's talk about it simply!

When you go to the hospital, before a doctor starts giving you some medicine, or does something like an operation , he explains it to you in detail and asks you, 'Are you okay with this?' That's what we call 'Informed Consent' in medicine. This is not just a verbal thing, it is very important. Let's see why that is and what protection it gives you.

What is Informed Consent?

Simply put, informed consent is a formal conversation between you and your doctor or healthcare professional about the treatment or test you are going to have. This is required by law and by medical ethics. It involves clearly explaining to you what you are going to be treated for, what the benefits are, what the risks are, what the consequences are if you don't do it, and whether there are any alternative treatments .

Then you can ask any questions you have about it, find out more details, and finally, only say 'yes' to it if you are satisfied with everything and want it. If you say 'yes', that is what is called consent.

Imagine that you have to have a minor surgery. The doctor tells you, 'If you have this surgery, your condition will be much better, but you may experience some pain, you may have to stay in the hospital for a few days, and you may have a small scar.' You might ask, 'Are there any alternatives to not having this?', 'Will I be given anesthesia for this ?', 'How long will it take for me to be able to function normally after this?' Things like that. After discussing all of this, you will be fully understanding and happy with it.

Why is this informed consent so important?

Informed consent protects both you and the doctor who is treating you. It also ensures that you have all the information you need before starting treatment. This allows you to face treatment with more confidence , and it also prevents unnecessary problems and worries later on. Imagine, you were given some medicine, and it caused a side effect, but you were not told about it in advance. How frustrated and angry would you be? This helps to prevent things like that.

Another thing is, this gives you the opportunity to actively participate in your health care. This is a great help for you to make the best decisions for yourself. Rather than just saying, 'I'll do whatever the doctor says,' it's better to know, 'What's going on, why is this being done, what are the pros and cons of this?' That's your right.

What types of medical procedures require this informed consent?

Generally, if there are any risks involved in a test or treatment, you will almost always need to give informed consent. This includes not only physical risks, but also risks to your privacy. Your doctor will explain all of this to you, so you can decide whether you agree to it or not.

Informed consent is usually required for things like:

• When administering anesthesia: This means putting you to sleep before an operation, or numbing a certain area.
• When performing biopsies : This means taking a small piece of tissue from the body and examining it.
• Blood transfusions: This means when blood is given from outside sources.
• During cancer treatments : For example, when chemotherapy or radiation is given.
• During certain interventions during childbirth: for example, when using forceps delivery or when performing an episiotomy (a small cut in the vagina ).
• When participating in clinical trials: This means research into new medications or treatments.
• When doing genetic testing.
• When medical devices are installed in the body (medical implants): for example, a pacemaker, or metal plates in a bone graft.
• When performing any type of surgery, whether it's small or large.
• When treated with high-risk medications: For example, when giving strong painkillers like opioids.
• Tests performed by inserting an instrument into the body: For example, during an endoscopy.

In addition, you must obtain informed consent whenever your personal medical records are transferred to another person or location.

How do I give my informed consent?

Giving your informed consent means you are telling your doctor or healthcare professional, "Okay, I'm willing to do this." It means you understand what they have explained and you are ready to make a decision.

Sometimes you may be given a document to sign . It usually says that you understand the risks, benefits, and other options. However, signing the document does not mean that you have to continue doing it. You can change your mind at any time – after you have given your consent, before the treatment begins, or even during the treatment (you should discuss the feasibility of this with your doctor).

Remember, signing is not just a formality. It means that you have made a conscious decision. So, if something is unclear or unclear, don't be afraid to ask again and again.

Who makes these rules regarding informed consent?

In different countries of the world, there are various institutions that create laws and guidelines regarding this informed consent. For example, in the United States, government agencies and medical associations prepare laws related to this. In addition, institutions such as ministries of health and medical councils in each country are also concerned with this.

In Sri Lanka, there is a code of ethics that doctors must follow through institutions like the Sri Lanka Medical Council (SLMC) . It also clearly mentions the importance of obtaining informed consent. The main thing is to protect the rights of the patient and give the patient the ability to make informed decisions. Therefore, this is a basic medical principle that is accepted anywhere in the world.

Are there special cases where informed consent cannot be given/is not required for treatment?

Yes, there are some emergencies where doctors have to treat you without going through the process of obtaining full informed consent. Here are some of those situations:

• If you need immediate treatment, but you are unable to speak or understand: Imagine that you have been in an accident and have been brought to the hospital unconscious. The doctors will start the necessary treatment to save your life without asking you. Because the most important thing at that time is to save your life. However, if possible, they will talk to your family, or tell you the details after you regain consciousness.
• If you are too ill to make decisions: For example, if you are in a coma or are very ill, doctors will check to see if you have an advance directive, which is a document that states who should make decisions for you if you lose consciousness and what treatments you want or don't want. Or, they will check to see if there is someone who can legally make decisions for you (such as a close relative).
• If you are a minor (under 18 years of age): Your parents, legal guardian, or other similar person usually makes health decisions for you. However, in some countries, the law allows young people over a certain age to make their own health decisions in certain special circumstances (e.g., sexual health issues). In Sri Lanka, parents or guardians usually give consent for those under 18.

Also, sometimes if a patient clearly states that they do not want the informed consent process , the doctor can proceed accordingly. But that happens very rarely.

Finally, a few things to remember

Okay, so now you have a good understanding of what we've been talking about, called ``Informed Consent.`` Remember, it's essential for doctors to get your permission before they give you any test or treatment. This process of informed consent is there to help you understand what you're agreeing to and why it's important.

Sometimes, you may feel nervous and confused about giving consent because you don't understand the medical terms your doctor uses. Especially if you are receiving emergency treatment, you may feel helpless and have difficulty thinking clearly. But you are not helpless. The informed consent process gives you the time you need to understand everything. Don't be afraid to ask any questions or get more information until you are completely confident in your decision. If you can, it is also a good idea to include a trusted family member or friend in the conversation.

Your health is in your hands. Make informed decisions, ask questions, and understand. It's your right! Also, don't forget that you have complete control over the treatment you receive.

` Informed Consent, Medical Treatment, Patient Rights, Health Care, Surgery, Medical Tests