How to Ensure Informed Consent Is Truly Taking Place
By David Fetterolf, Stratus Video President
Informed consent enables patients to make knowledgeable decisions about their own healthcare and medical conditions. When patients are informed about their healthcare options, they tend to actively engage and make decisions with providers in their healthcare plans.
In order to receive informed consent, the provider must disclose information pertaining to the treatment, test or procedure, including any risk or benefit as well as the likelihood that any risk or benefit will occur.
The patient must have the ability to make a decision, understand the information provided and grant consent without persuasion by part of the provider. The decision making capacity of the patient can be greatly impacted by language barriers, hearing loss and/or impairment.
Without a firm grasp of the English language, patients with limited English proficiency (LEP) are unable to understand options, implications, risks or benefits surrounding the disclosed information. This makes obtaining informed consent more challenging. It can, however, be achieved with the assistance of a medical interpreter who is trained, qualified and bound by a professional code of conduct. Deaf and HoH patients may require the use of an American Sign Language (ASL ) and/or Certified Deaf Interpreter (CDI) to ensure that meaningful access to healthcare information is taking place.
Informed consent can not take place with the use of an ad-hoc interpreter, as they lack a sophisticated understanding of medical terminology and may alter communication of delicate conversations. Ad-hoc interpreters are family members, bilingual staff and any other unqualified individual serving as an interpreter. Section 1557 of the Affordable Care Act (ACA) now restricts hospitals from using ad-hoc interpreters, barring extreme circumstance.
In order to ensure that informed consent is truly taking place, healthcare facilities are obligated to assess patient language needs prior to offering a service and render language services as needed.
A recent study by the National Institutes of Health revealed that English speaking patients were significantly more likely than LEP patients to have full documentation of informed consent. Less than 45% of LEP patients were provided with interpretation, sight translation and/or document translation of the consent form in their preferred language. This indicates an underutilization of language services in healthcare.
Informed consent is an important aspect of ethical medicine practice. The practice of obtaining informed consent has been shown to result in better patient engagement and outcome. To learn more about the importance of obtaining informed consent from all patients, including LEP and Deaf/HoH patients, watch our educational webinar “Informed Consent: Understanding What Makes Communication with Deaf/HoH and LEP Patients Effective”.