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The number of invasive investigations and therapeutic procedures undertaken by cardiologists across the UK is expanding rapidly. The speciality has seen major advances in the technological armoury that can be deployed to investigate and treat our patients, and our awareness of the need to maintain high standards of clinical training and expertise is generally robust. Furthermore, the evidence base expands and provides us with a mandate to investigate and intervene in ever increasing numbers of clinical settings. Despite all of this, cardiologists receive no formal training in the process of consent. In addition, few consultants personally obtain consent from their patients for the majority of the procedures that they are responsible for. In fact, it is often the case that the patients who are at the very highest end of the risk spectrum, by virtue of their need for emergency treatment (cardiogenic shock or rescue angioplasty, for example), are consented by the most junior members of the medical team.
CONSENT: TWO ASPECTS
Consent is a process that can be seen to consist of two intertwined agenda. First, there is the clinical priority to provide the patients (and often their relatives) with an adequate amount of information about the proposed procedure so that they are in a position to make an informed decision as to whether they want to go ahead with it. Fundamental to this is that they understand the procedure itself and the risks that are associated with it, as well as the options that are available apart from that particular choice. Done properly this has the potential to be a time consuming process. How do we know that we have done it “properly”? How can we be sure that what has been said to or read by the patient has been understood?
The second aspect of consent is the increasing need …