@C7RKY I think it was you who was reading my criticisms of ReSPECT? If it was you, and if you've looked - who do you think is right, ReSPECT or me?
It was me. And I still have multiple pages open on my laptop on the subject. Want a 2nd read. Consent is a huge soapbox subject for me anyway, so I'm inclined to side with you. I think you're right to focus on the form too - that will drive behaviours as much as any other factor.
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I'm very keen on 'getting the forms legally correct' because I feel sure that many healthcare professionals 'take their legal understanding' from the 'implications of the form'. Especially when there isn't much time for training - such as now!
@DrMarkTaubert doesn't quite agree. -
For different reasons, you and I have a shared desire to ensure that a consent form is designed in such a way as to provoke the right behaviours in clinicians: https://twitter.com/ShaunLintern/status/600735704101031936 … So what's
@DrMarkTaubert's position on this issue then?
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Actually I'm more interested in records of conversations and decisions (especially best-interests decisions) during end-of-life (especially if patient is at home) being signed-off from 'all sides' - not so much 'normal consent forms'. What are our 'different reasons'?
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I think your tweet demonstrates our different reasons pretty well actually. But we both want the patient's wishes accurately recorded and respected. Just in different scenarios.
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I'm not at all clear about your reasons - basically, 'I'm very strong on patient self-determination and on properly-performed best-interests decision making if the patient isn't capacitous'.
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And yours is an honourable pursuit. My interest is in ensuring that those who ARE capacitous, have their consent decisions respected. In particular, I am trying to tighten the consent form design to help prevent fraudulent amendment of its contents after the fact.
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I do 'capacitous' - but in the context of having Advance Decisons (which are refusals of treatment) respected by clinicians, especially by 999. Your issue seems to partly involve consent forms being looked at retrospectively (for example, after a death during an operation)?
End of conversation
New conversation -
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Mind you, when the consent form is divided into two parts - 'HCP' & 'patient' - the HCP fills out what he thinks the patient's answers 'should' be before handing the form to the patient, & senior management seem to think that's AOK, what hope is there? https://whobyf1re.wordpress.com/2014/06/16/the-conference/ …pic.twitter.com/65WmgUpAlX
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I can tell from the quality of your blog that you'll already realise this, but the consent form is recognised as being a record of a conversation. A conversation that is required in order for consent to be valid. It's pretty hard to document a conversation you haven't had yet!!
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I'm a bit confused by this consent form discussion [I've never signed a consent form]. Can someone tweet an image of an actual consent form, or post a URL to an actual form, so that I can try and see what is being discussed? Seemed to be a URL to an article?
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I think they vary depending on place & procedure. There's usually quite a lot of small print on them (read & strike out/initial anything you don't agree to) & fair bit of white space for HCP to write in (cross through blank space before signing).
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Well - can someone post a real form, which they have an objection to? Not what has been written on a consent form - the blank form itself.
End of conversation
New conversation -
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