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Bridging the Gap: Promoting Health Equity through Informed Consent
Conclusion
Eduard Vaynberg
Developing appropriate nonverbal communication skills with patients and coworkers can bring numerous benefits to all parties involved. It has the potential to significantly transform the relationships we establish with our patients, fostering a strong sense of trust and advocacy. Effective nonverbal communication begins with self-awareness and an understanding of how our actions and subtle physical cues impact those around us. Once we have a deep recognition of how our body language can influence the environment, we are able to harness various aspects of nonverbal communication to create a safe, open, and respectful atmosphere that inspires trust among the patients we treat and the colleagues we assist.
Learning Objectives 1. Understand the historical evolution of informed consent in medical practice. 2. Recognize the impact of minority distrust in medicine on a patient’s ability to make informed decisions about their healthcare and identify the various factors contributing to health inequity for minority populations. 3. Appreciate the importance of tailoring one’s approach to obtaining informed consent to each patient’s perspective.
Introduction Obtaining informed consent from patients is a fundamental aspect of clinical medicine and research, because it ensures that patients have a clear understanding of the procedures and potential consequences before receiving treatment. While it is now an established standard of care, the concept of informed consent is relatively new. Previously, a paternalistic approach prevailed, and physicians made decisions on behalf of patients without disclosing relevant information. However, the practice evolved over time, driven by legal precedents and a cultural shift toward respecting personal autonomy and individual rights. Today, informed consent is widely accepted but varies in its content and cultural implications across different societies. Understanding the history and importance of informed consent is essential for healthcare providers to navigate diverse patient perspectives and address disparities in healthcare access and trust, particularly among minority populations. This article explores the evolution of informed consent, the impact of cultural differences, and the need for effective and meaningful consent to promote patient-centered care and address health disparities.
Suggested Reading 1
The requirement for informed consent is a relatively recent development, considering the
Kleinsmith, A., De Silva, P. R., & Bianchi-Berthouze, N. (2006). Cross-cultural differences in recognizing affect from body posture. Interacting with Computers, 18(6), 1371–1389. https:// doi.org/10.1016/j. intcom.2006.04.003 2 Rezende, R. de, Oliveira, R. M., Araújo, S. T., Guimarães, T. C., Santo, F. H., & Porto, I. S. (2015). Body language in health care: a contribution to nursing communication. Revista Brasileira de Enfermagem, 68(3), 490–496. 3 Seppälä, E. (2017). When giving critical feedback, focus on your nonverbal cues. Harvard Business Review. Retrieved June 1, 2023 from https://hbr.org/2017/01/when- giving-critical-feedback-focus- on-your-nonverbal-cues 4 Vlachoutsicos, C. (2012). Your body language speaks for you in meetings. Harvard Business Review. Retrieved June 1, 2023 from https:// hbr.org/2012/09/your-body- language-speaks-for
historical practices in medicine. History of Informed Consent
In ancient times, physicians, in a paternalistic mindset, made decisions on behalf of their patients. For instance, Hippocrates advised concealing information from patients in Greece, revealing nothing about their condition. Similarly, in India, treatment permission was sought from authorities rather than patients themselves. During the Middle Ages, physicians were regarded as instruments of God and did not feel the need to justify their actions, believing that healing was determined by divine will. The earliest evidence of patient informed consent form can be traced back to a contract signed in Spain in 1900, involving medical research volunteers participating in a Yellow Fever study led by Dr. Walter Reed, a U.S. Army physician. However, it was not until the mid- 20th century, following several court decisions, that informed consent for medical procedures was formally introduced. Salgo v. Leland Stanford Jr. in 1957 established the distinction
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PROMOTING HEALTH EQUITY THROUGH INFORMED CONSENT 75
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