Sunday, August 13, 2017

The Problems with Informed Consent

PA Supreme Court mandated attendings must obtain informed consent. That decision is regulatory quackery designed to deny access to care. It violates the constitution by placing an undue burden. This phrase  was used to strike down laws restricting abortion times many in US Supreme Court decisions. It is undue because it has no effect on treatment outcomes. All regulation should be proven safe and effective or it is regulatory quackery, an intentional taking by government, and a type of fraud if one understands the Rent Seeking Theory, theft. Medicaid abuse is defined as the payment for a procedure that is not necessary. The PA Supreme Court should mandate an additional payment to doctors for its decision, and then get arrested for suborning Medicaid fraud. If they refuse to mandate an additional payment, I demand they mow my lawn for free.
Here are the problems with informed consent:

1) There is no informed consent. Give a 3 hour lecture on a treatment. Test the patient 15 minutes later, they know nothing about it, nor do most want to. Most just want the problem to go away;

2) patients and guardians have a duty to Google, with the internet available to 100% of the population, along with chats by patients receiving the treatment, including disgruntled ones;

3) patients are not qualified to decide the specifics of treatment; I do not want to know anything about piloting a plane. I just want to get to Chicago. Nor do I wish to learn anything about the disgusting management of plumbing, I just want the toilet to flow again, and to stop flooding the bathroom;
4) there is no informed consent because the patient has a gun to the head consisting of extreme motivation by pain, the threat of death, the loss of normal function from the disorder;

5) the sole informed consent is the question of the patient to the doctor, what would you do personally in this situation? That is the sole real question, that actually is beneficial. The answers can be shocking. For example, the answer from many cancer specialists is not what they tell patients, radiation, chemo, surgery. It is, I would go home, play with grandchildren.

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