Informed Patient Decision Making and the Use of Prescription Medications: A Canadian Dermatologic Perspective
Michael I. Singer and Neil H.
Shear
Background: Informed consent
is a potentially beneficial component of medical practice and a
basic obligation of physician to patient. Society, in general,
and the courts, in particular, have increasingly emphasized the
principles of individual autonomy and patient rights, and they
have begun to more rigorously require physicians to inform and
consult with patients before initiating treatments. Nevertheless,
the lack of sufficient information disclosure to patients has
become an increasingly common allegation in legal actions against
physicians. It has been shown that physicians' undertaking of
what constitutes informed consent is not always equivalent to the
legal definition. While informed consent is generally applied in
investigative medical research and before surgical and other
invasive procedures, general medicine and dermatology patients do
not commonly undergo a process of informed and formal decision
making before commencing therapy with sometimes potent
medications that often have potentially serious side effects.
Objective: The purpose of this
article is to explore and clarify the legal concept of informed
consent as it applies to the use of prescription medications and
to offer dermatologists a strategy to make drug use safer, both
medically and legally.
Conclusion: In light of recent
legal trends including the proclamation of the Ontario Consent to
Treatment Act, as well as the application of the " learned
intermediary" rule in cases of medical negligence involving
lack of drug risk disclosure, Canadian health care practioners
are well advised to become familiar with the concept of informed
consent and how it applies to prescription medications.
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