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Medical consent is an inalienable right

I recently listened to a regrettable tale from a friend of another friend. One of their kin had been experiencing some unusual symptoms, and the diagnosis was elusive. She eventually ended up at the hands of surgeon who recommended surgery. Nothing was found, but something entirely incidental and of no clinical relevance was apparent on one of her organs. The surgeon just removed it, even though that wasn’t necessary, and there wasn’t any prior consent. Worse still, the organ in question wasn’t within the said surgeon’s area of expertise.

It doesn’t end there. The surgeon only casually mentioned that he removed something else. He hid behind his bloated ego and didn’t bother to give more details or justify his actions. He even unashamedly billed extra for the additional operating he had done! There wasn’t any prior consent, or cross-consultation with other specialists. The patient had been unnecessarily over-treated and over-billed. She was understandably dissatisfied. Her rights to consent had been violated.

Such tales aren’t uncommon, but they shouldn’t occur in the first place. Patients should never get any interventions done without their consent. The only exception is in dire emergencies and incapacitating situations that dictate life-saving interventions. Anything else can wait for patients to fully understand the apparent diagnosis, consider different treatment options, then make a choice and give appropriate consent. No doctor, whatever their level of expertise, has the right to carry out any non-life threatening procedures without due consent. If they do, they have crossed a red line, and the law isn’t on their side. Period.

Whenever you seek medical help, make sure you get a full understanding of what is being proposed, and what isn’t. Ask questions in order to have a clearer understanding of your diagnosis and treatment options. Almost inevitably, you’ll be asked to sign consent documents especially if a procedure requires to be done. Verbal consent may sometimes be enough for mundane stuff. Never sign any consent forms without reading them through. You don’t even have to sign there and then. You could always think over a situation which isn’t urgent, come back and discuss again, then only consent if completely agreeable. Always remember that you can also refuse any advice given, even if it was in your best interests. You wouldn’t need to sign any consents in such cases, and nobody should unduly persuade you to.

If you find yourself in a situation where something has been done without your consent, you should seek appropriate redress. Your doctor is the immediate point of call, or any other appropriate person within the healthcare facility. Sometimes you will get an objective explanation which you might accept. Other times, as in the tale narrated here, a medical misdemeanor may have been committed. An apology would be required, or the situation might escalate to a medico-legal pathway.

Dr Alfred Murage is a Consultant Gynecologist and Fertility Specialist.amurage@mygyno.co.ke

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