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Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA

ICEA Statement on Informed Consent

Informed Consent. This phrase has come up in a number of discussions over the last few months. I wanted to share a portion of a paper from ICEA called "The Pregnant Patient's Bill of Rights - The Pregnant Patient's Responsibilities". The following portion discusses informed consent. (The section on patient responsibilities covers paying your care giver!!!!!)

ICEA constantly seeks to expand awareness of the rights and responsibilities of pregnant women and expectant parents. Most pregnant women are not aware of their rights or of the obstetrician's legal obligation to obtain their informed consent to treatment. The American College of Obstetricians and Gynecologists has made a commendable effort to clearly set forth the pregnant patient's right of informed consent in the following excerpts from pages 66 and 67 of its Standards for Obstetric-Gynecologic Services.

"It is important to note the distinction between 'consent' and 'informed consent'. Many physicians, because they do not realize there is difference, believe they are free from liability if the patient consents to treatment. This is not true. The physician may still be liable if the patient's consent was not informed. In addition, the usual consent obtained by a hospital does not in any way release the physician from his legal duty of obtaining an informed consent from the patient.

"Most courts consider that the patient is 'informed' if the following information is given:

* The processes contemplated by the physician as treatment, including whether the treatment is new or unusual.

* The risks and hazards of the treatment.

* The chances of recovery after the treatment.

* The necessity of the treatment.

* The feasibility of alternative methods of treatment."

"One point on which courts agree is that explanations must be given in such a way that the patient understands them. A physician cannot claim as a defense that he explained the procedure to the patient when hew knew the patient did not understand. The physician has a duty to act with due care under the circumstances; this means he most be sure the patient understands what she is told."

"It should be emphasized that the following reasons are not sufficient to justify failure to inform:

1. That the patient may prefer not to be told the unpleasant possibilities regarding the treatment.

2. That full disclosure might suggest infinite dangers to a patient with an active imagination, thereby cause her to refuse treatment.

3. The patient, on learning the risks involved, might rationally decline treatment. The right to decline is the specific fundamental right by the informed consent doctrine.

The rest of the paper discusses issues such as the right for the woman to know if the prescribed therapy is part of a contained study, and the right to refuse to participate in said study. If you are interested in the complete paper please contact the International Childbirth Education Association (ICEA) at:

ICEA Bookcenter PO Box 20048 Minneapolis, MN 55420 USA 1-800-624-4934 & Fax: 1-612-854-8772