Consent forms are required in order to fulfil the doctor’s obligation to involve patients fully in decisions of a critical nature concerning their care. Failure to obtain consent could expose a practitioner to a claim, complaint or criminal charge.
Documentation for consent should include a signed consent form which includes:
procedure-specific risks and outcomes;
checklists of support material (brochures, diagrams, DVDs etc.) provided to the patient;
particular information about risks material to the patient’s circumstances;
a statement which the patient signs, to the effect that they had an opportunity to ask questions, and had them answered to their satisfaction;
contemporaneous notes in the patient file documenting consent discussions with the patient;
a copy of any information brochures, diagrams or photos given to the patient should also be included in their notes.
A medical specialist has been prosecuted for professional misconduct and had their registration suspended after forging consent forms for over 30 patients.
The doctor performed elective surgery at a community hospital.
The behaviour was uncovered when another hospital took over the specialist services at the community hospital. During this handover it was reported that some of the doctor’s patients had claimed they had not signed the appropriate consent forms for surgery.
Following a hospital investigation, the matter was handed over to AHPRA and the police. An examination of the doctor’s past patient admissions revealed they had forged the signatures of 37 patients for surgical operations, procedures or medical treatment over a 12-month period.
The Medical Board of Australia referred the doctor to the tribunal submitting that the conduct breached the Good Medical Practice, a Code for Conduct for doctors in Australia.
The doctor admitted to forging the consent forms and conceded the action amounted to professional misconduct.
The doctor had become frustrated with administrative burden when new elective surgery admission forms were introduced; a simple one-page form was replaced with a complex, eight-page form which the doctor felt caused issues if the nature of the operation changed between the time the forms were originally signed to the date of the operation. Further, the doctor felt the form was difficult to complete for persons of non-English speaking background.
The tribunal found the doctor’s conduct constituted professional misconduct, stating that it was not just a mere act of oversight or a demonstration of lack of skills. It was a deliberate pattern of fraudulent conduct, striking at the heart of the doctor-patient relationship and taking away the patient’s ability to exercise an informed consent to the operation.
In handing down the doctor’s penalty, the tribunal took into account that the patients’ care had not been compromised, the doctor’s previous flawless record and their remorse for their actions.
Ultimately, the tribunal suspended the doctor’s registration for six months and imposed conditions on their registration including the completion of education courses on informed consent.
Post by Cameron Leaver and Claudine Watson-Kyme