I enjoyed Dr. Michael Glick’s August JADA editorial, "Informed Consent: A Delicate Balance" (JADA 2006;137[8]: 1060–2). Informed consent is an increasingly important topic in the dental setting. I wish to further emphasize a couple of points.
Gaining a patient’s informed consent before treatment is required in all dental procedures, from the most routine to the most invasive. A properly written consent form is an invaluable document in this regard, and one that is grossly under-used in the dental setting.
The consent form has several roles, rooted in both ethical and legal foundations. Ethically speaking, it provides the patient with the expected benefits of a given procedure, the reasonable risks involved and the alternatives to not having the procedure performed.
Outlining these factors in the written form helps elevate the quality of discussion between the patient and the provider. Invariably, the patient asks better questions, triggering better responses from the provider. This discussion helps incorporate the patient more completely into the treatment plan, allowing the patient to exercise his or her patient autonomy more fully.
Legally speaking, a properly written and signed consent form is an admissible legal document. In the rough-and-tumble world of litigation, a signed consent form can be an invaluable asset to a dentist’s defense. Perhaps even more importantly, a properly written and signed consent form may act as a deterrent to potential litigation in the first place.
Finally, whether detailed case notes are employed and/or a consent form is used, neither is considered a substitute for a thorough oral discussion before treatment. Discussing the intimate details of the procedure (including risks, benefits and alternatives), as well as allowing time for patients to comprehend these facts and have their questions satisfactorily answered, is imperative. However, a consent form, while not acting as a substitute for an oral discussion, offers a legal presumption that such a discussion has transpired.
Whether the perspective be legal or ethical or both, gaining a proper informed consent is a "virtue of good dental practice."
