The Role of the Patient

• Although a physician is required to inform a patient about benefits, risks, and alternative treatments, patients must also play a part in the informed consent process. Patients must listen to the physician and should ask questions of the physician if they do not understand, or if they would like more detailed information.

• Example: You are a patient in a hospital being treated for a problem with your back. Your physician comes into your room and says, "John, you've got a herniated nucleus pulposus. Let's do a discectomy and to do that we'll start you off with some sodium thiopental, then hit you with a strong general anesthetic and wheel you into the OR. We'll hope that while you're under the knife you don't have a myocardial infarction. Sound good?" You should look your physician in the eye and say, "I have no idea what you just said so I won't say that plan sounds good. Explain it to me in detail and tell me exactly what all of those words mean."

Situations in Which Informed Consent May Not Be Necessary

• Situations Not Involving Medical Procedures or Treatment. Not all situations require that informed consent be given. For example, although listening to a heartbeat through a stethoscope may be considered a "treatment" or "procedure," to some people (especially those who are uncomfortable in physician's offices), it's rare that a physician and patient would have a lengthy discussion about the benefits and risks of listening to a heartbeat using that device.

In other situations, informed consent is an absolute necessity. For example, in any medical trials or experiments that receive federal funding, informed consent must be obtained from any human participant or subject. This requirement stems historically from the Nuremberg Trials that took place after World War II where the atrocities of Nazi medical experimentation on unwilling subjects came to light. Following the trials, the Nuremberg Code was drafted which emphasized the need for consent in any human medical experimentation.