The Small Print of Informed Consent

"We cannot just walk into patients' rooms and tell them they need surgery and give them an unintelligible form to sign," says Harlan Krumholz, a cardiologist and professor of medicine at Yale University who is working with several groups to improve the informed-consent process. This was taken from an article entitled “Consent Forms that Patients Can Understand” published on February 6^th in the Wall Street Journal (http://online.wsj.com/public/article/SB120224055435844931-Kd_AIJddvdLapwheyVvcLlQlbLQ_20080306.html?mod=tff_main_tff_top) This was great to see because after reading the article, I began to wonder how many times I have signed a long article with small print without reading it?

This issue of obtaining informed consent via signature but without the patient receiving any real knowledge reminds me of the fiduciary duty of doctors to patients that we read about in Dying Children and Medical Research: Access to Clinical Trials as Benefit and Burden. I got to thinking about why, especially in the fiduciary relationship of doctor to patient, there would be so much small print. Is it not part of the fiduciary duty to keep the patient fully informed? I think it should be. The main purpose of all the small print in consent forms is to protect against lawsuits and angry patients. However, if patients were fully informed via simpler educational methods, many of the lawsuits could be avoided and the doctors would actually be better protecting themselves. I thought it was great to see in the Wall Street Journal article that some hospitals have reverted to simple electronic means of educating patients about operations. Hopefully more of this can be implemented throughout the world of medical practice so that I don’t have to worry about giving away my signature.