Informed Consent and Patient Rights
Informed consent is a process, not a signature. The exam tests the elements of valid consent, capacity, documentation, exceptions, and patient rights such as access, privacy, respectful treatment, and grievance.
Required elements
- The diagnosis and nature of the proposed treatment.
- Material risks and benefits, including foreseeable complications.
- Reasonable alternatives, including no treatment, and their risks.
- The consequences of refusing.
- A voluntary decision by a patient with capacity, documented in the record.
Special situations
Minors generally require a parent or guardian, but some states allow minors to consent to limited services. Emergency exceptions permit treatment when delay would risk serious harm and no authorized decision-maker is available. Telehealth may require separate consent and identity verification.
Worked example
A patient signs a consent form for a crown. The dentist never discussed extraction or root canal as alternatives and did not mention the risk of pulp exposure. The form lists “crown” and “risks.” The consent is weak because the patient did not receive the information a reasonable person would need. A signed form does not substitute for the discussion, and the note should reflect what was said.
Traps
- Treating a signed form as conclusive proof of consent.
- Assuming consent is a one-time event; it continues and can be withdrawn.
- Delegating the consent discussion to untrained staff.
- Obtaining consent after sedation has compromised capacity.
- Ignoring informed refusal, which must also be documented.
Exam focus
Look for who explained what, when, and with what documented evidence.