1. INFORMED CONSENT SAN ANTONIO COMMUNITY HOSPITAL September 28, 2006 Snyder, Walker & Mann

2. WHAT IS CONSENT? Acceptance or approval of what is planned or done by another; acquiescence. Informed consent is a legal condition whereby a person can be said to have given permission to go forward with medical care or treatment based upon an appreciation and understanding of the facts and implications of this care or treatment.

3. WHAT IS CONSENT? Affects Various Rights: Fundamental right over the control of one’s body. Personal rights. Property rights.

4. WHEN IS CONSENT NECESSARY? General Rule: No treatment without risk of liability unless patient has consented. Types Of Consent Simple Informed Exceptions Special Procedures

5. WHO MAY GIVE CONSENT? Adults Minors – without capacity to consent Minors – with capacity to consent

6. CONSENT: ADULTS What is an adult? Capacity to make decisions Married patients Power of attorney/surrogate Conservatorship None of the above

7. WHAT IS AN ADULT? Reached age 18 Minor in a valid marriage On active duty in military Emancipated minor

8. CAPACITY TO CONSENT A person’s ability to understand the nature and consequences of a decision, to make and communicate a decision, and the ability to understand the significant benefits, risks and alternatives.

9. CAPACITY TO CONSENT Respond knowingly and intelligently to questions about the medical treatment Participate in the treatment decisions by means of rational thought process Understand: Nature and seriousness of illness Nature of recommended treatment Benefits, risks, consequences & alternatives

10. CONSENT FROM OTHERS Married patients Without other legal relationship, no consent Power of attorney/surrogate Written power of attorney/healthcare agent Conservatorship Letters of conservatorship LPS Act None of the above

11. MINORS WITHOUT CAPACITY Parents Married Divorced Step parent Out of wedlock Registered domestic partner Guardianship Third party consent

12. MINORS WITH CAPACITY Emancipated Active duty military Married or previously married Contraceptive care Reportable diseases Victims of rape/sexual assault Mental health treatment Drug/alcohol related

13. HOW IS CONSENT OBTAINED? General Considerations Physician Hospital Alternate Methods

14. HOW IS CONSENT OBTAINED? General Considerations Freely Obtained Express Implied In Writing

15. HOW IS CONSENT OBTAINED? By The Physician Verbally Consent Form Document Chart

16. HOW IS CONSENT OBTAINED? By The Hospital Procedure Practitioner Medical Information Time & Date of Signature Witness Copies for Patient & Chart Verify Consent Obtained By Physician

17. HOW IS CONSENT OBTAINED? Alternate Methods Telephone E-Mail Facsimilie

18. HOW IS CONSENT OBTAINED? Communication & Cultural Barriers Interpreter Translated Documents

19. WHY IS CONSENT NECESSARY? Battery Professional Negligence False Imprisonment Invasion of Privacy & Defamation