Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지
DOI QR코드

DOI QR Code

Enhancing Professional Awareness of Informed Consent : Safeguarding the Rights of Patients and Practitioners

  • Min Ji Kim (Healthcare, Legal and Policy Center, Legal Research Institute of Korea University)
  • Received : 2024.06.24
  • Accepted : 2024.09.26
  • Published : 2024.11.01
Download PDF
⟨ Previous Next ⟩

Abstract

Informed consent is a crucial communication process between doctors and patients for obtaining patients' approval before initiating medical treatment. It is derived from the legal principles of medical contracts and requires doctors to explain the treatment process to patients. Surgeons should be aware of informed consent not only to avoid unnecessary litigation risks but also to provide patients with the right to self-determination. The aim of the study is to help surgeons in Korea understand the legal doctrine on informed consent for practical application. This article reviews the legal doctrine of informed consent according to 5W1H-why, who, whom, what, when, and how-with judicial cases to communicate effectively with patients in clinical settings. Irrespective of the seniority and rank of a doctor, they have the responsibility to provide patients with the information required to protect their right to self-determination. Informed consent should be advanced for patients to consider, discuss with significant others, and determine whether or not to undergo medical treatment. At that stage, patients need to be informed of the necessity, risks, and so on. The most common method of informed consent is an oral explanation utilizing certain forms for documentation. However, the informed consent of patients can be exempted on certain occasions. Optimal informed consent, when implemented, leads to patient-centered care, which significantly improves patient satisfaction and outcomes. Ultimately, it not only protects doctors from litigation risks but also upholds patients' autonomy.

Keywords

References

  1. Alomar AZ : Confidence level, challenges, and obstacles faced by orthopedic residents in obtaining informed consent. J Orthop Surg Res 16 : 390, 2021 
  2. American Medical Association : The AMA Code of Medical Ethics. Available at : https://code-medical-ethics.ama-assn.org/ 
  3. American Medical Association; New York Academy of Medicine : Code of medical ethics. New York : H. Ludwig & Company, 1848 
  4. Baek K : A study on recent discussions ahout the pysician's explanation in medical litigation. Korean Soc Law Med 24 : 37-63, 2023 
  5. Baek K, Ahn Y, Kim N, Kim M : A study on the nurse in charge of education's current status and legal status. Korean Soc Law Med 14 : 261-280, 2013 
  6. Beauchamp TL : Autonomy and consent in Miller FG, Wertheimer A (eds) : The ethics of consent: theory and practice. New York : Oxford University Press, 2010, pp55-78 
  7. Beauchamp TL, Childress JF : Principles of biomedical ethics, ed 8th. New York : Oxford University Press, 2019 
  8. Berg JW, Appelbaum PS, Lidz CW, Parker LS, Berg JW, Appelbaum PS, et al. : Exceptions to the legal requirements: emergency, waiver, therapeutic privilege, and compulsory treatment : Informed consent: legal theory and clinical practice. Oxford : Oxford University Press, 2001 
  9. Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K : Low health literacy and health outcomes: an updated systematic review. Ann Intern Med 155 : 97-107, 2011 
  10. Buchner B, Freye M : Informed Consent in German Medical Law: Finding the right path between patient autonomy and information overload. Bremen : Proceedings of the Young Universities for the Future of Europe Law Conferences, 2021 
  11. Chin JJ : Doctor-patient relationship: from medical paternalism to enhanced autonomy. Singapore Med J 43 : 152-155, 2002 
  12. General Medical Council : Guidance on professional standards and ethics for doctors: Decision making and consent. Manchester : General Medical Council, 2020 
  13. Giudici-Wach K, Gillois P, Remen T, Claudot F : Learning from informed consent litigation to improve practices: a systematic review. Patient Educ Couns 105 : 1714-1721, 2022 
  14. Huang D : The concept of "self-government" across cultures: from the western world to Japan and China. Cultura 15 : 53-72, 2018 
  15. Hyun D : A critical review on informed consent in the revised Medical Law. Korean Soc Law Med 18 : 3-35, 2017 
  16. Jang C : A study on the doctor's explanation of obligation: on the basis of protective interests. Ajou Law Rev 13 : 80-100, 2019 
  17. Jefford M, Moore R : Improvement of informed consent and the quality of consent documents. Lancet Oncol 9 : 485-493, 2008 
  18. Korea Medical Dispute Mediation and Arbitration Agency : Medical dispute mediation and arbitration statistical yearbook 2023. Seoul : Korea Medical Dispute Mediation and Arbitration Agency, 2024 
  19. Lee JH : Explanation duty of doctor in case the malpractice suit. J Law Res 12 : 5-38, 2014 
  20. Lin YK, Liu KT, Chen CW, Lee WC, Lin CJ, Shi L, et al. : How to effectively obtain informed consent in trauma patients: a systematic review. BMC Med Ethics 20 : 8, 2019 
  21. Park J, Park H : Surgical informed consent process in neurosurgery. J Korean Neurosurg Soc 60 : 385-390, 2017 
  22. Quill TE, Brody H : Physician recommendations and patient autonomy: finding a balance between physician power and patient choice. Ann Intern Med 125 : 763-769, 1996 
  23. Rubenfeld J : The right of privacy. Harv Law Rev : 737-807, 1989 
  24. Seoul Central District Court : 2014Gahab509854. Decision of May 18, 2016 
  25. Shah P, Thornton I, Turrin D, Hipskind JE : Informed consent : StatPearls [Internet]. Treasure Island : StatPearls Publishing, 2023 
  26. Shin HH, Baek KH : The theory and practice of medical disputes. Seoul : Parkyoungsa, 2022 
  27. Suk H : The functional classification of physician's duty of information and liability for violation of the duty. Korean Soc Law Med 18 : 3-46, 2017 
  28. Supreme Court of Korea : 2005Da5867. Decision of May 31, 2007 
  29. Supreme Court of Korea : 2009Da17417. Decision of May 21, 2009 
  30. Supreme Court of Korea : 2009Da70906. Decision of Nov 24, 2011 
  31. Supreme Court of Korea : 2021Da265010. Decision of Jan 27, 2022 
  32. Supreme Court of Korea : 94Da3421. Decision of Jan 20, 1995 
  33. Supreme Court of Korea : 94Da35674. Decision of Nov 25, 1994 
  34. Supreme Court of Korea : 99Da10479. Decision of Sep 3, 1999 
  35. Suwon High Court : 2020Na22793. Decision of Oct 13, 2022 
  36. The Joint Commission : Informed consent: more than getting a signature. Quick Saf 21 : 1-3, 2016 
  37. Uijeongbu District Court : 2015Gadan111549. Decision of Dec 7, 2016 
  38. The Emergency Medical Service Act. Amended by Act No. 19654, Aug 16, 2023 
  39. The Medical Service Act. Amended by Act No. 19421, May 19, 2023 
  40. The Constitution of the Republic of Korea. Wholly Amended by the Constitution No. 10, Oct 29, 1987