Features  |   February 2013
Informed Consent and Shared Decision-Making
Author Affiliations
  • Colleen E. O’Leary, M.D.
    Committee on Professional Liability
  • Karen B. Domino, M.D., M.P.H.
    Committee on Professional Liability
Article Information
Ethics / Medicolegal Issues / Features
Features   |   February 2013
Informed Consent and Shared Decision-Making
ASA Monitor 02 2013, Vol.77, 14-15.
ASA Monitor 02 2013, Vol.77, 14-15.
A 28-year-old ASA Physical Status 1 female soccer coach underwent knee arthroscopy for anterior cruciate ligament repair under uncomplicated general anesthesia. A femoral nerve block was performed for postoperative pain relief using ultrasound guidance. The patient developed a femoral neuropathy, requiring surgical lysis of adhesions, with persistent weakness. After a year, she filed a malpractice claim alleging inadequate informed consent for the nerve block. The anesthesiologist had discussed the block but did not document the informed consent discussion or the risk of nerve damage or persistent weakness. A settlement of $65,000 was made on behalf of the anesthesiologist.
Obtaining informed consent is an ethical obligation of the practice of medicine and a legal requirement per statute and case law in all 50 states. Patients have the right to make decisions regarding their well-being without coercion from others. Informed consent requires a thoughtful dialog between physician and patient wherein sufficient information is offered so that the patient can make an educated decision. Unfortunately, physicians often do not share the information patients need to make an informed decision.
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