Did the doctor ask you for a signature? Let's learn everything about Informed Consent!

Have you ever been in a hospital? Or have you ever been to see a patient? You probably remember when, before a major operation or a special test, a doctor or nurse would bring a file and say, "Sign this." There are times when we all sign without thinking much. But did you know that that signature is not just a mark on a piece of paper, it is the most important decision you will make regarding your health? That's what we call "Informed Consent."

What is 'Informed Consent'?

Simply put, informed consent is the process of getting your consent by fully informing you about the treatment or test you are going to undergo. It's not just a signature. It's a very important conversation between you and the doctor who is treating you.

In this conversation, there are a few things that the doctor needs to explain to you:

• What treatment/test will be done: What exactly will be done to you? What is it called? How will it be done?
• Benefits: What will you gain from this treatment? Will your illness improve? Will your symptoms decrease?
• Risks and side effects: All medical procedures carry some risk. For example, the possibility of a wound becoming infected after surgery, the possibility of an allergic reaction to anesthesia, or the potential side effects of certain medications. All of these should be explained to you clearly.
• Other options: Are there other treatments you could choose besides this one? What are they? What are their pros and cons?
• What will happen if you don't get treatment: What could happen to your health if you refuse this treatment.

After explaining all this, the doctor should give you the opportunity to ask any questions you have. If you understand everything and say, "Okay, I'm happy with this," that's what is called "Giving Consent." This is something that is mandated by law as well as the code of medical ethics.

Why is this informed consent so important?

Imagine you're planning a trip with a friend. Your friend doesn't tell you where they're going, how much it's going to cost, or what they're going to do. If they just say, "Let's go," would you go? No. You only go after you've heard all the details and are comfortable with it. That's how it is with this.

The process of informed consent protects both you and the doctor.

• The security you get: You know exactly what's going to happen to you. So you don't have to say, "Oh, I didn't know this would happen." You have the final say in what you do with your body. This gives you a lot of confidence and peace of mind.
• Protection for the doctor: When everything is explained and treatment is performed with the patient's consent, legal issues and misunderstandings that may arise later can be largely avoided.

Simply put, this makes you an active participant in your own healthcare. You are not just a recipient of treatment, but a part of the decision-making process.

What kinds of things require informed consent?

In general, your informed consent is required before any test or treatment that involves any risk. This includes physical risks as well as risks to your privacy. The table below clearly shows some of these situations.

Additionally, if personal information, such as your medical records, is provided to another person or organization, your consent is also required.

What does it really mean to say 'I gave my consent'?

By signing and giving consent, you are stating, "The doctor explained everything to me, I understand it all, so I would like to have this treatment."

But the most important thing here is this.

You don't necessarily have to do it just because you signed it. You can withdraw your consent at any time, not just before the treatment starts, but even after it starts if you feel like you need to stop.

This is your basic right. If you have any doubts or feel uncomfortable, you have the full right to ask to stop the treatment at any time.

Are there special cases where informed consent is not required?

Yes, in some emergencies and special cases, doctors have to treat without this entire procedure. Here are some such cases:

• When there is an emergency: Imagine that a person who has been unconscious after a serious road accident is brought to the ETU (Emergency Treatment Unit). He cannot speak, he does not even know who he is. But an emergency operation is needed to save his life. In such a situation, doctors start treatment with the aim of saving life, without waiting for the patient's consent. But they also try to find and inform the family as soon as possible.
• When the patient is too ill to make a decision: A person who is in a coma or is mentally incapable of making a decision cannot give their consent. In such cases, consent is obtained from the legal guardian or next of kin.
• Children under 18: Generally, under Sri Lankan law, medical decisions for a child under 18 are made by the child's parents or legal guardians. Therefore, if a child undergoes something like surgery, they are the ones who need to sign and give consent.

When we need medical treatment, especially if it's an emergency, we can feel a little scared and anxious. We may not understand the words the doctors say, the medical terms. At times like that, we may think, "Oh, I can't decide these things."

But remember, you are not helpless. This process of Informed Consent is designed to empower you. Ask questions until you understand. Ask not just once, but ten times. Don't be afraid to ask, "Doctor, I didn't understand what you said, could you explain it again in simple terms?" That is your right. The most important thing is to make the decision about your body with full understanding.