CONSENT CONVERSATION AND DECISION-MAKING STANDARDS 1

Consent conversation, Decision-making standards, and Advanced care directive.

Student’s Name

Institutional Affiliation

Tutor

Course

Due date
CONSENT CONVERSATION AND DECISION-MAKING STANDARDS 2

Abstract.

A consent conversation is an on-going, act-specific, and embodied dialogue. Decision-

making involves coming up with choices by pointing out a resolution, collecting facts, and

gauging possible resolutions. There are specific decision making-standards that have to be

considered.

Question 1

The concept of well-executed, informed consent conversation is a critical device of

patient-centered medicine. It stresses the significance of patients actively taking part in their

care. It also includes the doctor's evaluation of the patient's knowledge of the information

provided and their ability to make decisions regarding treatment (Ripley et al., 2015). Patients

have the right to choose among medical alternatives. Unless the patient’s ability to make

decisions is impaired, the patient can legally refuse to take treatments.

Informed consent includes the following elements; victual of information, evaluation of

the patient's understanding, assessment of the capacity of the patient or surrogate to come up

with the needed decisions, and the persuasion that the patient has the liberty to choose among

the medical options without threatened force or manipulation (Ripley et al., 2015).

A well-executed informed consent conversation includes; respecting the patient's

autonomy, developing a thorough understanding of the clinical situation, and the patient’s

opportune ability to active choices with concern to the circumstances (Appelbaum 2007).

Informed consent is historically associated with invasive procedures (Applebaum 2007).

Principles of informed consent can be used in any medical decision where one or more medical

choices exist, including judgement about medications and medical visualization.

CONSENT CONVERSATION AND DECISION-MAKING STANDARDS 3

The conversation can be unfruitful if the patient does not have sufficient knowledge to

make the right decision.

Question 2

When making care decisions for patients, health care agents, and surrogates, decision-

making standards should be highly considered. These decision-making standards include the

subjective standard, substituted judgment, and the best interests standard (Pope 2012).

The subjective standard refers to the implementation of the patient's instructions. The

patient may speak directly to the treatment decision in a way that is sufficiently clear to the

clinician. Without the patient having expressly given the surrogate freedom, the agent must

bring about what the patient has already decided. The surrogate is the inferior means to

safeguarding patient capacity to make an informed decision (Pope 2012). Subjective hands-on

evidence of the patient's decision about their health-care treatment is preferable.

The subjective standard tends to:

i) Protect the patient’s autonomy.

ii) Create an opportunity for shared decision-making.

iii) Include information regarding the benefits, alternatives, and risks of the proposed

care plan.

iv) Ensure patient understanding is sufficient to make an informed decision.

Question 3

An advance care directive is also known as a living will. It is a formalized version of

one's advance care plan. It outlines one's preferences for future care together with their beliefs,
CONSENT CONVERSATION AND DECISION-MAKING STANDARDS 4

values, and goals. This means that someone can formally appoint a substitute decision-maker

(Pope 2012).

There are two main elements in an advance directive; a living will and a durable power

of attorney for health care. An advance care directive formalizes one's advance care plan. The

directive can contain all your needs, values, and preferences for one's future care and details of a

substitute decision-maker.

Making an advance care directive is necessary for advance care planning. One can only

make a valid advance care directive over 18 years and have decision-making capacity.

Substantial efforts are being made to increase and improve advance care planning and the

accuracy of surrogate decision-making (Pope 2012). The shift from a legal transactional

approach to a communications approach is a crucial development. The approach emphasizes

iterative discussions with family members and physicians, often facilitated by increasingly

sophisticated toolkits, workbooks, and interactive applications.

An advance care directive can include; the person who would like to be their substitute

decision-maker, details of what is important to them, or treatments and care that one would like

or would refuse if they have a life-threatening illness or injury.

Conclusion.

Despite the call for improvement of the informed consent conversation, the obstinate

deficits may develop from the absence of a proper tool to educate or assess communication
CONSENT CONVERSATION AND DECISION-MAKING STANDARDS 5

skills or the absence of complete realization about the extent/impact of limited health education.

Attention to informed consent conversation should be given a high chance, and improvement

should be highly considered.

The importance of surrogate decision-making supersedes its risks. Also, the current

ways to protecting and promoting patient’s prospective autonomy are defective. There are

noticeable opportunities for improvement, but agent decision-making remains the best approach

to protecting a patient's anticipated autonomy.

More and better-advanced care planning will inform and guide surrogate decision-

making. Advance care directive outlines one's preferences for future care together with their

beliefs, values, and goals. It should be considered in cases where a substitute decision-maker is

needed.

References.
CONSENT CONVERSATION AND DECISION-MAKING STANDARDS 6

Beth A. Ripley, MD, Ph.D., David Tiffany, JD, Lisa S. Lehmann, MD, Ph.D., and Stuart G.

Silverman, 2015; final revision.

Paul S. Appelbaum, M.D.. November 1, 2007. N Engl J Med 2007; 357:1834-1840. DOI:

10.1056/NEJMcp074045. Article; Figures/Media.

Pope, Thaddeus Mason, Legal Fundamentals of Surrogate Decision Making (2012). Chest, Vol.

141, No. 4, p. 1074-1081 (April 2012).

Will JF. A brief historical and theoretical perspective on patient autonomy and medical decision

making: part I: the beneficence model. Chest. 2011 ; 139 ( 3 ): 669 – 673.