Date of Medical Observation
August 2006
Narration
“A Man is a master of his own body.”
Every human being of
adult years and sound mind has the right to determine what shall be done with his body.
This MAR narrates the story of these
two patients of mine and the difficulties I encountered concerning the acquisition of an informed consent.
A 17-y/o male was diagnose to have acute appendicitis. He was accompanied by
his work-buddy until he was admitted. The operation was booked on
the night of his admission.
His parents and relatives
stay in Bicol. He just came here in manila all by himself. He works as a boy-helper to make a living.
My problem then was
whom to get an informed consent before I could be able to operate on him.
A 49-yo female had a history of fall sustaining head injury 5 days before
she was brought by her employer. She complaint of headace, neck pain and
left sided body weakness.
She was conscious, coherent, oriented to person ,
place and time at the time of examination. Glasgow
coma scale was 15/15. Cranial CT scan revealed a fronto-temporal hematoma.
my senior told her employer that an immediate
operation is necessary. We then asked for the whereabout
of the patient’s family or the husband perhaps.
Too bad they live in Zambuangga city.
Who is going to sign an informed consent in behalf of this patient?
<!--[if !supportLists]-->n<!--[endif]-->Insight, Discovery, Stimulus
<!--[if !supportLists]-->n<!--[endif]-->Physical, Emotional, Psycho-social
A surgeon who performs
an operation with out the patients consent commits an assault for which he is liable for damages.
This MAR
aims to review our medical jurisprudence with regards to proper acquisition of informed consent for every procedure we indulge
in.
So, who can give consent?
According to the book
of Medical Jurisprudence by Solis, the persons who can give consent are the following..
The
patient himself.
A patient may give consent to whatever medical or surgical procedure to be applied on his body provided he is of legal
age, of sound mind and not otherwise disqualified by law.
Generally, a minor cannot
give consent. A person is considered a minor when he is below the age of 21 but when
he is emancipated, a minor can still give consent.
“So,
my patient can sign the consent in behalf of himself even if he is a minor.”
If the patient is a
minor, consent must be obtained from the parents. The father and mother jointly exercise parental authority over their legitimate
children who are not emancipated.
In case of disagreement,
the father’s decision shall prevail, unless there is judicial order to the contrary.
In the absence of the
parents, the consent must be obtained from the grandparents. Substitute parental authority shall be exercised by the grandparents
in the following order:
<!--[if !supportLists]-->n<!--[endif]-->Paternal grandparents
<!--[if !supportLists]-->n<!--[endif]-->Maternal grandparents.
In the absence of parents
and grandparents, then the eldest brother or sister, provided he or she is of age, and not disqualified by law may give consent.
Other persons who may give consent in their capacity as substitute parental authority.
<!--[if !supportLists]-->n<!--[endif]-->Guardians
<!--[if !supportLists]-->n<!--[endif]-->Teachers and professors
<!--[if !supportLists]-->n<!--[endif]-->Heads of children’s homes, orphanages and similar
institutions.
<!--[if !supportLists]-->n<!--[endif]-->Directors of trade establishments, with regard to apprentices.
Consent may be granted
by the court.
If certain medical or
surgical procedure is necessary to save the life or preserve the health of a child and the parent or the persons who is responsible
to give consent refuses to give it, then the court, upon petitions of the physician or any person interested in the welfare
of the child, may issue an order giving such consent.
In these particular
cases that I presented, it was justifiable to proceed with the contemplated procedure. Make the patient sign the consent in
behalf of himself.
END
