Informed Consent

Informed consent is a process through which the healthcare professional informs the patient about the treatment he or she will receive, as well as the risks, benefits and alternatives. This information and understanding process finishes in the signing of the written informed consent form, a document in which the patient authorises the performance of the medical service. This signature must be made consciously and voluntarily by the patient, who can accept it or reject it. The objective is that the patient can make decisions regarding his or her health according to his or her own free will. In addition, it is verified that the patient has received and understood the information provided by the professional responsible for his or her treatment. The current state regulation of information and consent is included in in Law 41/2002, of November 14th, the basic regulator of patient autonomy and of rights and obligations in matters of clinical information and documentation. As its name indicates, it shows respect for fundamental rights such as autonomy and self-determination, where the patient, after receiving adequate information, will make his or her own free.

According to the current legislation (Law 41/2002) any action in the field of a patient's health requires the free and voluntary consent of the affected, in addition, in the case of the example provided, as it is a dental extraction, which can be considered as an invasive procedure since it involves certain risks, must be collected in writing. According to my personal experience, since I have recently had to undergo two endodontic procedures, I have previously been given information about what the technique consists of, as well as its possible consequences and complications. In addition to this, on the day I had them performed, I was previously given the informed consent document, collecting  all the fundamental information that had already been given to me beforehand so that it was recorded that I had been adequately informed on the basis of my needs and therefore authorised to finally carry out the procedure. The patient's consent has to be given before the intended action, once the appropriate information has been provided. Whenever possible, information should be provided sufficiently in advance to allow the patient to reflect and ask for any clarification he or she considers necessary for a decision to be taken.

From my point of view, despite the fact that I do not consider it necessary to present the signature of a document before any health procedure that may involve the slightest risk, I believe that in this case it would be necessary to have it and, if there are still professionals in Spain who do not request it, it should become a common practice, since this procedure results in multiple complications, however, on the other hand, we must not forget that information and consent are verbal processes, and written forms must be used exceptionally.

On the other hand, I believe that dentists, as professionals in the health field, must be obliged not only to the correct provision of their techniques, but also to the fulfilment of the duties of information and clinical documentation, and to respect for the decisions freely and voluntarily taken by the patient. The healthcare professional must inform the patient and respect the decision made by the patient in accordance with his/her values and his/her life project, as a clear expression of his/her autonomy, the written document of informed consent is a tool that facilitates the process of communication and a necessary complement to verbal information that allows to attend several needs.

The document presented here does not meet the minimum requirements required by our regulations, the information regarding the explanation of the procedure is minimal, although we must not forget that the information to include should not be exhaustive but sufficient for the patient to make a representation of the significance of the act on which he/she will consent, however, lacks a brief description of the procedure as well as the steps to be taken. On the other hand, it mentions the need to apply local anaesthesia, however, it does not deepen into this aspect and neither does it provide information about the inconveniences and complications that may arise from the use of it.

Finally, it has drawn my attention the fact that the document does not include the health professional's data, it only refers to the patient's identification data. Besides, it mentions that, "although the document is neither read nor understood, it has been verbally explained". As regards to this, one of the minimum requirements that our Autonomy Law demands is that the information provided must be adequate, adapted to the needs and understandable, which will help the patient to make decisions in accordance with his own free will.