Taking consent for a procedure can be easy for some people, but for others, it might be challenging. Developing a good relationship with the parents, legal guardian or anyone who has been given the authority by law might make the thing more comfortable but not everyone knows how to develop a good relationship with others quickly. Last semester I had the opportunity to witness some of the skills displayed by my supervisor, doctors and other medical related professions, in taking consent to carry out a procedure. It worth noting that, the difficulty in obtaining consent will depend on how far the consenter understands about the method or how greatly influenced they are by stigma.
In Orthopaedic posting, I’ve observed countless of time either in clinic or ward on how medical doctors take consent for any surgical procedure or treatment changes due to the deterioration of the patient’s condition. Usually, patient doesn’t make much fuss about it and most of them agree/consented to the suggestion given by the medical doctor. In paediatric posting on the other hand, consent is difficult to obtain due to overprotectiveness, excessive worries and stigma. I understand a child is precious and sometimes we’re getting in our head so much that even any knowledge or medical education being given earlier rendered completely useless.
I’ve been posted to Hospital Tuanku Fauziah when I was in the Paediatric posting. From experience getting consent from the patient who lives in the rural area is much easier than people who live in the urbanized area. What I’ve realized is that, in Kangar, most of the parents put a high expectation and trust on a medical doctor to treat their own children. Sometimes, they were asking for some explanation regarding the treatment or procedure that was suggested by medical doctors, but most of them wanted to see how confident the treating doctor is. I knew this because I’ve asked some of them and I can say about 80% of them doesn’t understand or put an effort to do so when the medical doctors gave them the explanation, but they consented the treatment plan.
This is something different and if people from the urbanised area such as Kuala Lumpur asked a doctor to explain, they either persistently wanted to understand, or they wanted to confirm either the treatment plan was the same like what has been suggested on the internet. That was a lousy one. Most of us (someone from a medical background) know that explanation which has been provided on the internet is usually general in application. Unless the one who was asking are reading medical journals or something, there will always be some contradictions between the information they learn and the information they received from a treating doctor. This makes getting consent tricky and complicated. Despite all of the hurdles, I can say most of the doctors that I observed, did excellent work. They knew how to approach patient and how to handle incorrect information.
There are so many things that we need to learn to improve our skills in forming a good and mutual relationship between a doctor and a patient. Trying to explain as best as I could without using any medical jargon to the patient so that they would understand and consent would be the most crucial step.
