In addition to determining the patient's competency to consent to medical treatment, the physician must impart the appropriate information to obtain consent. In some circumstances, physicians may invoke therapeutic privilege and do not have to disclose extremely rare risks or complications that, if disclosed to the patient, may unreasonably prejudice the patient's decision. 4 of 7 Distinctions are made among various types of consent. When patients present to the ED, they typically sign a general consent during the registration process. General consent indicates that the patients are willing to undergo basic evaluation and treatment.
Controversy exists regarding the definition of basic treatment.
Few argue that taking vital signs or performing a routine physical examination requires the physician to obtain further consent from the patient. Ideally, physician-patient discussion should be witnessed and written documentation of consent obtained. In an emergency, attempt to obtain informed consent from the patient or from an appropriate surrogate decision maker. In certain situations, emergency consent is implied. In these instances, normal consent standards are not followed because immediate treatment may be required even before an opportunity to obtain consent is available.