Ethics & Law · patient case question
After all treatment options, risks and side effects have been explained and the surrogate agrees, what is the resulting document called?
Patient case: Consent for a patient who cannot consent for himself
Patient: Male, 74 years old, in a wheelchair
Chief complaint: Wife: “He's here for his extractions.”
History: Hypertension, hyperlipidaemia. Stroke two years ago with residual cognitive deficits. His wife is the court-appointed legal guardian. Medications: lisinopril, atorvastatin, warfarin.
Findings: Non-restorable teeth #30 and #31 planned for extraction today.
Show answer and explanation
Correct answer: A. An informed consent form
- A. CORRECT. INFORMED CONSENT is the documented result of a disclosure and decision process. The required elements are the diagnosis, the nature and purpose of the proposed treatment, its risks and benefits, the reasonable ALTERNATIVES with their risks and benefits, and the consequences of doing NOTHING — the last two being the ones most often omitted. Consent must be given voluntarily by a person with capacity or an authorised surrogate, and the signed form is evidence of the conversation, not a substitute for it.
- B. Informed refusal documents a patient's decision to DECLINE recommended treatment after the same disclosure. It is equally important to record but is not what happened here.
- C. A treatment plan is the clinical sequence of proposed procedures. It informs the consent discussion but carries no legal authorisation by itself.
- D. An advance directive is a document made in advance by a person with capacity, setting out their wishes for future care should they lose capacity. It is not created at the point of treatment.
Note: Consent is a PROCESS, not a signature. A signed form obtained without a genuine discussion does not protect anyone, and consent can be withdrawn at any point.