Providing a truly informed consent is both essential and beneficial for any individual receiving medical treatment. At its core, it is to ensure that permission is given with the full knowledge of the proposed treatment details along with any relevant benefits, risks, and alternatives. This concept is critical in both emergent and elective medical treatments.
Informed consent is not only an invaluable way to educate patients, but also serves to empower the patient, giving them autonomy in exercising their right to seek out a procedure, and to support their desires whether that be to consent or not.
Informed consent in the medical care of transgender and gender non-conforming patients has been an area of great interest and variability. Traditionally, some gender affirming procedures have required a thorough evaluation by a mental health professional, but this degree of pre-procedure evaluation was not always uniformly utilized and the specific consenting processes have been varied and unstandardized depending on geographic location and specific treatment.
Healio recently published an article regarding variations in consent forms for gender-related care based on research presented by Samhita L. Nelamangala at this year’s Virtual Women in Medicine Summit. The study examined pubertal suppression and gender-affirming hormone therapies, and the resulting relationship of consent between a triad of: patient, clinician, and parent. The study included comparative coding of 28 consent forms and an analysis of the results. The article focused on the marked discrepancies that Nelamangala and her colleagues discovered in their research findings related to consent, stating that “due to the considerable variability between consent forms, the researchers concluded that the role of these forms in engaging participation and assent of minors in these treatments needs additional development and clarification.” This lack of consistency can be dangerous for both the patient and the provider, especially considering the life-altering impact of these treatment options.
With all procedures, including those involving gender affirming therapies, as a patient or a provider, you want to be sure you are getting/giving the highest quality information in an understandable and personalized manner, while in a neutral setting so that a truly informed decision is made. So how can we provide this ideal setting each and every time without absorbing the same limitations uncovered in the Healio article?
At Confirmed Consent we work with several of the country’s busiest and most-experienced gender affirmation surgeons who have dealt with this in their practice. In switching to our interactive consenting platform, these clinicians were able to ensure that procedure information and education was delivered in an easily understandable, personalized, and standardized fashion that the patients (and their loved ones) could review as often as needed, and provide consent while confirming that they are in the correct state of mind to do so. In addition to our patient satisfaction scores being nearly 100%, our surgeons have been thrilled with how it has improved not only their practice, but their patient satisfaction and engagement with consent.
“Using Confirmed Consent has greatly enhanced our practice’s efficiency, ability to relay complex information to patients, and has protected us legally. Patients watch our hour-long videos detailing procedures multiple times. We have noticed the questions from patients have decreased significantly, thus shortening needed time for consultations. Being able to watch the videos several times allows the patients to absorb more information critical to informed consent.”
As a provider you are oftentimes concerned with malpractice claims and litigation. With the specialty of gender affirmation, this risk can be very high. The procedures you are doing are life changing and permanent. This also ensures you want your consent process to be detailed and diligent, so you can address issues before surgery if there are concerns. However, inevitably issues may arise after the fact that may be known complications. Here is how one of our gender affirmation surgeons responded to this topic when using Confirmed Consent.
“Over the past three years there have been two occasions where a disgruntled patient that unfortunately suffered from a known and accepted complication from their specific procedure requested medical records in an attempt to pursue legal action against my practice. In both instances, no attorney was willing to take the case, I believe, because the confirmed consent videos were so explicit in the potential risks and the test at the end of the video proves an understanding of the risks and decision-making capacity. I will always use Confirmed Consent in my practice.”
We believe that as a medical community we need to always focus on how we can give our patients the best care possible. This goes beyond excellent surgical technique or diagnostic acumen, and extends to effective communication with our patients.An informed Consent is one of the most important parts of this communication process. Just as our diagnostic and therapeutic capabilities continue to expand, we must ensure that innovation also includes patient educations, safety, and quality. If you are a provider, think about your own consenting process and ask if it is being done to its fullest capability? Better yet, think back to the last time you were a patient, and whether you were happy with the way you were consented. Can we do better? We must do better!
As always, feel free to email us with questions at firstname.lastname@example.org and check out our website to request a demo at confirmedconsent.com. Stay tuned for our next blog post!