When anyone undergoes medical or cosmetic procedures in Australia (and in most developed parts of the world), doctors are required to obtain the patient’s informed consent for that procedure.
In a cosmetic and medical context, informed consent can be defined as the process by which a consumer makes decisions about participating in a medical treatment. Becoming familiar with the benefits of a procedure or treatment and the potential risks involved as well as learning about other alternatives to any given procedure are all-important parts of the decision-making process.
Here’s what the Medical Board of Australia says on the topic of informed consent in its Code of Conduct for Doctors in Australia:
Informed consent is a person’s voluntary decision about medical care that is made with knowledge and understanding of the benefits and risks involved. The information that doctors need to give to patients is detailed in guidelines issued by the National Health and Medical Research Council.
According to the Code, your doctor or surgeon should:
- Provide information to you in a way that you can understand before asking for your consent.
- Obtain your informed consent or other valid authority before they proceed with any examination, investigation or give you a treatment, other than in an emergency situation.
- Ensure that you are informed about your doctor’s fees and charges.
- Advise you of the possibility of any additional costs.
When issues of informed consent arise, often the “fault” is shared between the consumer and the surgeon who fails to sufficiently inform the patient about risks. However, because doctors and surgeons owe a duty of care, they are obviously better informed than the patient and are required to adhere to a certain method in obtaining written informed consent forms, they can be held responsible to a much higher degree.
According to a study entitled When informed consent goes poorly: a descriptive study of medical negligence claims and patient complaints and published in the Medical Journal of Australia in August 2011, “The typical dispute over informed consent involves an operation, often cosmetic, and allegations that a particular complication was not properly disclosed.” In seven out of ten disputes, the main allegation was that the doctor failed to mention or to properly explain risks and complications.
The Avant Mutual Group Limited and complaints lodged with the Office of the Health Services Commissioner of Victoria between 2002 and 2008, alleging failures in the informed consent process, based the study on negligence claims against doctor’s insured.
Here’s a brief summary about the study and its findings:
- Of the total 481 cases 57% were against surgeons.
- 69% involved female patients.
- Three out of four incidents occurred in privately owned health care facilities, with nearly two thirds occurring in consulting rooms.
- 92% involved surgical procedures and 16% were non-surgical.
- In 71%, the primary allegation was that the doctor failed to mention or to properly explain the risk of complications.
- Five treatment types —procedures on reproductive organs, procedures on facial features excluding eyes, prescription medications, eye surgery and breast surgery —accounted for nearly half of all cases.
The researchers noted in their discussion “the predominance of cases alleging undisclosed risks related to surgery is striking”. They also noted that high-profile court battles over informed consent in Australia, as well as in the United States, Malaysia, New Zealand, Ireland and Canada have centred on the same scenario. They observed: “Concerns about surgical risks not properly explained appear to be the heartland of contemporary disputes between patients and doctors over consent, at least in Australia”.
The statistics showed that one in six disputes related to cosmetic procedures. Because cosmetic procedures are elective, patients have high expectations and are less likely to tolerate risk. This is natural enough considering that complications are likely to be visible and patients have paid out of their own pockets to have the procedures done.
Disputes regarding informed consent were usually associated with substandard care in other aspects as well. Researchers acknowledged the possibility that “clinicians who have problems with the consent process also experience problems delivering other aspects of care.” They concluded it was likely that a mix of concerns “operate synergistically, producing a sufficiently negative perception of the overall care experience to move patients to complain or litigate.”
From a patient’s point of view, it is far cheaper, safer and more productive to be well informed about the procedure beforehand than to blame the surgeon later for not getting informed consent.
The other side of the coin: If you come across a shoddy practitioner who fails to take the time to discuss benefits of a procedure, its inherent risks and complications, how they can be averted or dealt with in your case, and what other options are open to you besides the proposed procedure, the last thing you should be doing is signing informed consent forms! Take to your heels and look for a more professional surgeon or cosmetic physician.
We always recommend shopping around for a surgeon. On one hand it gives you a wider perspective on possibilities, options and risks. It also gives you the opportunity to consider the different styles, approaches and ‘bedside manner’ of surgeons. That way, you can select a surgeon who inspires your trust and confidence.
If you are thinking of having a cosmetic procedure, do research on your own before making an appointment for an initial consultation. If that first consultation does not inspire confidence, it is worth shelling out some more money for a consultation with a different doctor.
Here are a couple of articles you might want to read before you go shopping: