Discussion Thread 6

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Liberty University *

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Medicine

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Dec 6, 2023

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Uploaded by ElderWombatPerson926

Informed consent is designed to provide knowledge of the risks and benefits of treatment and to empower patients in shared medical decision-making (Spertus et al., 2015). In the cardiac catheterization lab, informed consent is a required, legally mandated process to proceed with any type of procedure. According to Hyeon et al. (2020), insufficient doctor- patient communication and a negative view of the public regarding doctor authority have created a feeling of distrust toward doctors resulting in medical accidents being attributed to doctor negligence. Frizzell (2014) suggests that adequate informed consent is a “continual struggle to provide the appropriate amount of information at the appropriate level and to ensure that patient's appreciate complex medical information” (p.1). In this discussion thread, I will review over the issue of not providing proper informed consent to cardiac catheterization patients and possible solutions. Informed Consent issues in the cardiac catheterization lab Abbott & Williams (2017) state that patient preparation and informed consent are the most important aspects of cardiac catheterization. A well-informed patient will be less anxious and more cooperative. Even in emergent procedures in the cardiac catheterization lab, safety cannot be compromised by inadequate preprocedural assessment (Abbott & Williams, 2017). As the complexity of procedures in the cardiac catheterization lab increases, the likelihood of complications related to the procedure may increase despite the contribution of the procedures to better prognosis. According to a study reviewed by Spertus et al. (2015), only 10% of Medicare patients were offered alternatives to stenting and only 16% discussed their treatment preferences in the cardiac catheterization lab. Frizzell (2014) explains that because cardiac catheterization is a complex procedure with multiple variations, it is easier for the doctor to consent the patient for any potential interventions that could happen instead of trying to consent the patient in-between the diagnostic and interventional portions of the procedure. Informed consent in the cardiac cath lab can be difficult as many of these patients are being treated emergently and informed consent is rushed or absent depending on the patient’s condition. Potential Solutions Spertus et al. (2015) suggests that personalized consents address well known deficiencies in the standard consent documentation. In their study, they discovered that the novel consent forms could markedly advance the goals of the consent process and better empower patients in shared decision-making (Spertus et al., 2015). Spertus et al., (2015) also suggests that utilizing the redesigned consent form, including the use of embedded risk models, and providing more educational documents is a promising strategy to achieve both the ethical mandates of informed consent and encourages shared decision-making amongst patients and doctors. Frizzell (2014) suggests that incorporating awareness of patient self-efficacy and empowerment, especially in patients with low health literacy, can help with understanding the procedure during the consenting process. Biblical integration Galatians 6:2 states carry each other’s burdens, and in this way, you will fulfill the law of Christ (New International Version Study Bible, 2011). As healthcare professionals, we carry our patient's burdens and empower them to make the best medical decisions about their

care. By providing education of the benefits, risks, and alternatives during informed consent, we are empowering our patients. Spertus et al. (2015) has proven that patients are reading more of the personalized consent forms than the traditional forms. With this improvement, patients may understand the procedure better and able to ask better questions to help them make their decisions. References Dawn Abbott, J., & Williams, D. O. (2017). Patient selection, preparation, risks, and informed consent. Cardiovascular Catheterization and Intervention , 49–61. https://doi.org/10.1201/9781315113869-5 Frizzell, J. (2014, May 1). Patient and provider views on informed consent for cardiac catheterization: A pilot study . UNM Digital Repository. Retrieved March 9, 2023, from https://digitalrepository.unm.edu/biom_etds/80/ Hyeon, C. W., Lee, W., Kim, S. Y., Park, J. Y., & Shin, S. H. (2020). Prevention of medical malpractice and disputes through analysis of lawsuits related to coronary angiography and Intervention. The Korean Journal of Internal Medicine , 35 (3), 605–618. https://doi.org/10.3904/kjim.2018.365 Spertus, J. A., Bach, R., Bethea, C., Chhatriwalla, A., Curtis, J. P., Gialde, E., Guerrero, M., Gosch, K., Jones, P. G., Kugelmass, A., Leonard, B. M., McNulty, E. J., Shelton, M., Ting, H. H., & Decker, C. (2015). Improving the process of informed consent for percutaneous coronary intervention: Patient outcomes from the Patient Risk Information Services Manager (eprism) study. American Heart Journal , 169 (2). https://doi.org/10.1016/j.ahj.2014.11.008

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Discussion Thread 6

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