In health care today, consent is based on the concept of informed consent. The doctrine of informed consent developed from the law of negligence. The right to informed consent came about in the landmark 1957 decision Salgo vs. Leland and University Board of Trustees. In this case, a doctor was found negligent for failing to explain to a patient the potential risks of vascular surgery. Following the surgery, the patient became paralyzed.
All states have statutes or common law defining what constitutes informed consent.
Health care organizations must have policies for addressing informed consent procedures. An NP should obtain consent for all major therapeutic and diagnostic procedures in which disclosure of significant medical information, including major risks involved, would assist a patient in making an intelligent decision about whether to undergo the proposed procedure. Courts have extended a patient's right to informed consent to his right to informed refusal. It is imperative for providers to obtain a refusal of treatment form when a patient says no to treatment. If a patient refuses to sign a document appropriately in the clinical record, review your organization's policy on this matter.