Medicine requires extensive clinical practice, because of which it is an integrated mandate for all medical and para-medical degrees. Most healthcare professionals, including nurses would recall flocking around a patient, as senior clinician would explain the case, while patient would stare into oblivion. As a clinician, it is understandable that one would like to study any case considered out of the routine and ‘rare’, but the question is, “Is it acceptable to the patients?”
Mahima (name changed), a 26 year old, dynamic career-oriented software engineer, recalls one such incident.
Mahima had been experiencing painful and heavy menses for as long as she could remember, hoping that it would get better with time. With no improvement over multiple cycles, she visited a Gynecologist and was diagnosed with Uterine Fibroids, Grade 4 Endometriosis and Polycystic Ovarian Syndrome (PCOS). This is an elaborate and lengthy diagnosis even for strong-willed people like Mahima. Irrespective, she decided to undergo multiple surgeries, as suggested by doctors. This also meant innumerable invasive tests, both pre and post operatively. Mahima’s was a ‘rare’ case, due to her past surgical history. During one such post-operative procedure, Doctor doing the Ultrasound, signaled to his assistant to call other clinicians working at the premises to share and learn from this ‘rare’ opportunity. Mahima felt puny and embarrassed, while her case was being discussed, without her permission.
There are many people, who would have been in situation similar to Mahima, or at some point in time, wished that they were asked for permission. In the healthcare industry, practical experience is considered as important as theoretical knowledge. There is immense work load at hospitals and clinics on every employee, right from Ward boy, Nurses to Department Head, because of which, they may forget to take verbal consent.
Informed consent is applicable to invasive and surgical procedures, but it should be practiced as hygiene in routine practice. Professionals are very diligent about informed written consent during surgical procedures, which is a Patient’s right, but may falter when it comes to verbal consent. As a patient, it is essential to voice your concern at the very moment, and bring it to notice of your doctor, nurse or care giver, for benefit of others in future. According to Code of Medical Ethics (2002), doctor can share patient details if required by State law, referring to a specialist or protecting a healthy individual likely to get a communicable disease. At all other times, he/she must obtain verbal consent from the patient. There is abundant literature around the topic in developed countries like U.S. and Australia, where it is followed tenaciously.
In the past decade, Healthcare industry has undergone extensive changes incorporating technology with the delivery system which has made information and treatment more accessible. Though, some may argue that in course, personalized care or human touch, considered quintessential to the noble profession, are fading. It is important, that going forward all personnel in this field, treat the Patient like a Person.
Dr.Surbhi Bhatnagar Narain is a Dentist by training. After practicing at some of the leading hospitals in Delhi, she moved to Mumbai, and worked at Mirai Health, aspiring to bridge the gaps in healthcare industry. Currently, she is working at a global healthcare solutions company in Mumbai, India.