Wanted: Plain Language Consent Forms

Illustration of person signing a consent form.

Lately, we’ve been giving a lot of thought to something that comes up again and again in our plain language conversations: the medical consent form.

The consent form issue is a tricky one for a number of reasons — there are legal implications, and different doctors or hospitals might have specific requirements. There’s also the loftier ethical discussion about what informed consent actually is (and whether it’s truly possible to obtain it).

But without going too far down that road, we want to suggest that perhaps the conversation isn’t about the form itself, but rather when to get consent.

We know people’s ability to understand and use health information is affected by how sick, anxious, or scared they are. Why, then, do health professionals present these often unwieldy and confusing consent forms at the time of a health service or procedure?

Of course we acknowledge that emergency care is different and, depending on the circumstances, there may be no other choice. But there are many, many medical procedures that are not emergencies — and for those, health professionals often ask for patients’ consent minutes beforehand.

Our proposed solution? Move the consent form process (and discussion) to an appointment before the service takes place. Patients need to hear about the risks of the procedure before they’re sitting in front of the doctor in a gown.

Here’s an example: You’re going in for a colonoscopy. You’ve taken the day off from work, secured someone to drive you home, and fasted for a day. The nurse asks you to sign a consent form. Are you going to read it carefully? Is this the moment that you are going to ask your doctor about all your options?

We didn’t think so. And who can blame you? You’re hungry, anxious, and resigned. From the consumer perspective, the “consent” form was totally useless.

But what if you got all of the information and had the opportunity to discuss it with your doctor at your last appointment? Would you think a little bit more about what it means to sign on the dotted line? We bet you would.

The bottom line: To make consent forms truly effective, look at the whole process — not just the words on the paper.

 

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