Informed Consent

Informed Consent — agreement or permission accompanied by full information on the nature, risks, and alternatives of a medical procedure or treatment.

Comgetent Individual – A person who is mentally capable of understanding the nature of the procedure and associated risks who has reached the age of consent.

Sterilization – permanent method of contraception.

M.T.P. – Medical Termination of Pregnancy

1. Informed consent is obtained before surgery, anesthesia, procedural sedation, use of blood and blood products and other high risk treatments and procedures.
2. Consent must be taken by explaining to the patient/ family the following:
   1. Nature of the treatment or procedure
   2. Expected benefits, complications and risks
   3. Alternative courses of action
   4. Consequences of not undergoing the treatment or procedure
3. Any procedure or treatment that, in the judgment represents a potential medico-legal risk should complete an informed consent.
4. Exclusion: The following circumstances, only in the ER, do not require informed consent for procedural moderate sedation/ analgesia or procedure (but not limited to):
   1. Majorjoint dislocations or fracture dislocations.
   2. Displaced extremity fractures with severe angulations.
   3. Any fracture with evidence of distal vascular compromise.
   4. Major burns requiring immediate management and debridement 2″°’ degree and above
   5. Cardioversion for unstable dysrhthmias resulting in end-organ compromise.
   6. Emergency insertion of:
      1. Central venous catheters
      2. Chest decompression needles or drainage devices

• Pericardiocentesis needle drainage

1. Diagnostic peritoneal lavage catheters in the setting of trauma
2. Any necessary invasive procedure that is urgently required in a patient whose judgment seriously impaired by substances and where treatment delay could potentially result in significant patient harm.

5. All consent forms must be written in English and Arabic if patient’s first language is Arabic.
6. Any competent individuals may sign his/ her own consent form.
7. An adult female (i.e., has reached the legal age of 18 years) is legally responsible for herself and may consent to treatment (subject to local custom).
8. Minors (patient who are under the age of 18 years) or a person not physically or mentally fit to give consent will be exercised through their parents or other representative.
9. Minors who are not accompanied by their parent(s), spouse, closest adult male relative or other appropriate legal guardian:
   1. Shall not be treated if they presented with non-emergent conditions to the clinic or ER and inform Social Worker and the patient’s closest male relative or sponsor.
   2. Shall receive treatment without delay in ER for life or limb-threatening through emergent conditions while efforts are made to contact the patient’s closest male relative or sponsor.
10. Nursing Service Dept. personnel sign as a witness on consent forms, acknowledging they have witnessed the signing, not the explanation of the procedure (informed consent).
11. A second witness of consent can either be relative, friend, and attending doctor or sponsor if attending with the patient.
12. Duration of (all) informed consent forms:
    1. From the date a consent form is signed by the patient/ patient’s representative, it is “valid”:
       1. For single procedures — maximum of 15 days
       2. For repeating a single procedure — either for the number of procedures of the time period specified on the consent form (as part of the physician’s specific treatment regimen).
    2. Consent must be reobtained and redocumented:
       1. If more than 15 days lapse between the date the patient/ patient’s representative signs the consent form and when the procedure is performed (for a single procedure).
       2. If the condition of a patient admitted for a specific treatment or procedure subsequently changes significantly.

• If a different procedure is required.

13. For medical termination of pregnancy, patient and husband will sign two (2) forms: informed for medical termination of pregnancy, patient and husband will sign two (2) forms: informed consent and “Justification for MTP Counseling & Consent” form in English or Arabic.
14. in case of emergency where surgery, anaesthesia, use of blood and blood products, and other high-risk treatments is needed and the patient is unable to give consent and no relative or guardian or sponsor is available, the following will be followed:
    1. The attending physician must secure the agreement of another qualified physician after consultation that it is imperative to perform the procedure without delay.
    2. The attending physician and consulted physician will record in the patient’s file after agreement that the surgery is absolutely necessary without delay and signed by both physicians.
15. Any patient who refuses treatment or surgery, anaesthesia, use of blood and blood products, and other high-risk treatments deemed necessary by the treating clinician or who discharges him/herself from hospital will sign ”RELEASE FROM LIABILITY” form. As stated in “Refusal of admission, leaving against medical advice (LAMA) and/ or refusal to accept medical/ dental care” This form may be signed by inpatients, outpatients and Emergency Room patients.