Grant (1972) which shifted the standard of disclosure from physician-based to patient-based, and Canterbury v. Kline (1960) which marked physician liability through negligence, Cobbs v. Leland Stanford Jr University Board of Trustees (1957) formally marked the birth of the term “informed consent”. The process of informed consent was further refined through Natanson v. Society’s expectations around consent were further stimulated in the post-Nuremberg trial era. Davis(1906), Rolater v Strain (1913), and Scholendorff v Society of New York Hospitals (1914). In Scholendorff, Chief Justice Cardozo notably established the need for consent and reinforced a patient’s right to self-determination. Slater v Baker & Stapleton (1767) marked the first decision pertaining to informed consent in medicine, and further progress slowly continued through the nineteenth century. The twentieth century laid foundations addressing the medical battery component of informed consent through cases including Mohr v. Today’s informed consent policy structure derives significantly from English common law surrounding assault which is commonly described as one individual threatening physical harm to another and battery which is one individual physically contacting another without permission. This was further developed by Alexander the Great who after being wounded on the battlefield expressed his understanding of his situation to his doctors and asked them to treat him. The Middle Ages largely continued previous attitudes about patient participation and consent in decision-making, and they shifted only minimally toward increased patient inclusion during the Enlightenment period. The concept of consent for treatment extends at least as far back to the ancient Greek and Byzantine empires.Hippocrates and Plato both suggested the importance of patient buy-in prior to conducting an intervention, despite the then-status quo of not inviting patient involvement. Patients may restrict who may do what, especially if the value of the exam or intervention seems unclear. A particular scenario arises when care involves more intimate areas such as sexual health. There may be instances where patients do not want students involved despite agreeing to work with them in other capacities. The principle of autonomy dictates that patients have the right to accept a treatment plan as is, to request changes to the plan, and/or to decline care from any treatment programs, teams, or participating members including students. Patients are protected by guidelines set by the Joint Commission on Accreditation of Healthcare Organizations, and by tenets of biomedical ethics which include as basic principles the four pillars: autonomy, beneficence, non-maleficence, and justice. By agreeing to work with students, patients not only enable teaching experiences to be incorporated within their own healthcare experiences, they also help guide students in growing into their roles as integral members of a patient’s care team. They can learn, through their preceptors’ examples, how to empower patients in making informed decisions and how to balance evidence-based recommendations with each individual patient’s treatment preferences. In teaching hospitals specifically, medical students are often entrusted with the responsibility of interviewing and examining patients, synthesizing differential diagnoses, and recommending lab and imaging tests to their clinical preceptors as part of their learning processes. They may also acknowledge on their forms that students from various professions (medical, nursing, physiotherapy, etc) may take part in their treatment. Patients in hospitals complete forms providing general consent to treatment upon registration and admission. It could be that they simply trust physicians to provide care and make relevant recommendations. In reality some patients hardly think twice about what informed consent fully entails, what it allows, and what might call for detailed extra consent documents. Consent is indispensable to everyday society, enabling proper stewardship of people and resources whether used in general verbal communications or complex functions and transactions. In healthcare, a patient requesting treatment must provide informed consent, which is defined as “a process of communication whereby a patient is enabled to make an informed and voluntary decision about accepting or declining medical care.” Informed consent can only be given once a patient fully understands all relevant details pertaining to the medical options at hand, recommendations on interventions, and the potential risks, benefits, and consequences.
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