Informed Consent: Information or Knowledge?
Medicine and Law: World Association for Medical Law 2003; 22(4): 743-750
A fiduciary relationship should be nurtured between patient and physician. This requires effective communication throughout all aspects of care - especially pertaining to treatment decisions. In the context of illness as experienced by the patient a unique set of circumstances is presented. However, communication in an illness context is fraught with problems. The patient is vulnerable and the situation may be overwhelming. Voluminous amounts of information are available to patients from a host of health care providers, family members, support groups, advocacy centers, books, journals, and the Internet. Often conflicting and confusing, frequently complex, this information may be of greater burden than benefit. Some information is of high validity and reliability while other information is of dubious reliability. The emotional freight of bad news may further inhibit understanding. An overload of information may pose an obstacle in decision-making. To facilitate the transformation of information into knowledge, the health care provider must act on some occasions as a filter, on other occasions as a conduit, and on still other occasions simply as a reservoir. The evolution of patient rights to receive or refuse treatment, the right to know or not to know calls for a change in processing of overwhelming information in our modem era. In this paper we will discuss the difference between information and knowledge. How can health care providers ensure they have given their patients all necessary and sufficient information to make an autonomous decision? How can they facilitate the transformation of information into knowledge? The effect of knowledge to consent allows a more focused, relevant and modern approach to choice in health care.
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An act to amend the Human Rights Act of 1977 to prohibit employment discrimination based on genetic information; to prohibit an employer, employment agency, or labor organization from requesting or requiring a genetic test of, or administering a genetic test to, an employee or applicant for employment or membership; to prohibit an employer, employment agency, or labor organization from seeking to obtain, obtaining, or using genetic information of an employee or applicant for employment; to provide an exemption that allows the use of genetic testing or information with the written and informed consent of the employee or applicant for employment to determine the existence of a bona fide occupational qualification, investigate a workers' compensation or disability compensation claim, or determine an employee's susceptibility or exposure to potentially toxic substances in the workplace; to prohibit health benefit plans and health insurers from using genetic information as a condition of eligibility or in setting District of Columbia. Laws, statutes, etc. (2005-01-03)