More best practices on informed consent

The topic of informed consent has been discussed in the medical community for many years, yet there still exist problems with the informed consent process that many patients face. A recent article in JAMA noted that “… informed consent documents are often signed minutes before the start of a procedure, a time when patients are most vulnerable and least likely to ask questions…”

CHP recommends the use of the PARQ format for obtaining informed consent. Informed consent forms come in many sizes and content formats, but, for all providers, the basic rule is to include:

  • P = Procedures explained
  • A = Alternatives given and providers may choose to explain what may happen with no treatment rendered
  • R = Risks explained
  • Q = Questions from the patient

The PARQ format is designed to be used BEFORE the patient signs the informed consent document and includes both appropriate time for verbal discussion and proper documentation. (See our best practices blog post on PARQ here and documenting PARQ here.) The use of PARQ protects both the patient and the provider.

A recent trend in informed consent documents among multiple professions has been the addition of indemnification language. A sample of indemnification language seen in recent forms is below:

“The patient will hold the provider, all its agents, employees, family and corporation harmless from any and all claims, demands damages and causes of action present or arising in the future from any injuries or harm received during treatment, even in cases of negligence by the provider or its’ employees. I understand this release of liability and assumption of risk and fully accept this agreement, affirming with my signature.”

While indemnification language may seem like a smart provision for protections, providers are advised to check with their malpractice companies before using it. A chiropractic malpractice insurance carrier we consulted with advises against using this type of language in consent forms; University of Western States does not use indemnification language in its curriculum and advises against using it in practice. Local law firms also warn of the potential fallout if a case were to come before a judge or jury. Further, a provider may not indemnify against negligence when coming before a licensing board.

If you are currently using indemnification language on any of your forms, you are encouraged to consult with your legal counsel.