Talking to Your Doctor about Informed Consent

WHAT SHOULD YOU ASK YOUR DOCTOR BEFORE YOU SIGN A CONSENT FORM

What is informed consent?
You have a right to know about the benefits, risks and alternatives to any treatment you might receive. Physicians must get consent from a patient before giving any treatment. You have the right to accept or to refuse any treatment. When you sign a consent form, it means that you agree to receive the treatment chosen by you and your doctor. Informed consent also means you understand and accept the risks of that treatment.

Why might I need blood?

There are several reasons you might need blood during surgery or therapy.

• Some types of surgery may cause you to lose a lot of blood.
• Some illnesses like kidney disease, cancer, rheumatoid arthritis, and HIV/AIDS can cause your blood counts to drop.
• Persons with conditions such as thalassemia, sickle cell anemia, aplastic anemia or myelodysplasia may require healthy red blood cells to replace those that do not work effectively.
• Some treatments for cancer, HIV/AIDS, hepatitis C, or other diseases may also cause your blood counts to drop.

Ask your doctor if you might need blood during surgery or therapy.

Four questions to ask before giving consent for blood treatment

1. What are the benefits of increasing my blood counts?
2. What are the treatment options available to me, including donated blood, my own blood, or an alternative to blood?
3. What are the risks of the treatments I might receive?
4. What are the risks of receiving no treatment?

Who is responsible for giving you the information you need to make an informed decision?
The doctor providing your treatment (surgeon or specialist) is responsible for making sure you understand all the benefits and risks of your treatment, including blood, before you sign. In addition, the anesthetist, nurse, or family physician may talk to you about blood and alternatives.

When should you talk to your doctor about the need for blood or another blood treatment?
Informed consent for blood treatment must take place well before the scheduled surgery or therapy, from two to six weeks ahead of time. This allows you time to prepare and to choose a blood treatment alternative, if appropriate. Some of the alternatives must be started several weeks in advance.

Talk to your doctor about blood several weeks prior to your scheduled surgery or therapy.

Is there a separate consent form for blood?
Before you receive blood, you will be asked to sign a consent form. Different hospitals and other medical settings use different types of consent forms.
You may be asked to sign:

• a separate consent form just for blood treatment.
• a consent form for blood as part of the consent for surgery (or other treatment).
• a separate form to say you are refusing blood.

Ask your doctor about the type of consent form used in your medical setting.’

Is there a record of the informed consent?
A copy of the signed consent form is stored in your medical file. In addition, the doctor should write in your medical chart that he or she has talked to you about the benefits and risks of blood and blood alternatives. The doctor should note any specific concerns or questions that you had and the answers provided.

Make sure the doctor records your treatment choices in your medical chart and any specific concerns that you have about blood treatment.

WHAT SHOULD YOU ASK YOUR DOCTOR?

• What are the chances that my blood counts will fall low enough that I will need blood replacement therapy?
• What will I get in a blood transfusion?
• Are there other blood products that I might get?
• What are the benefits of receiving blood? What are the risks of blood? What are the risks of not receiving blood?
• What are alternatives to a blood transfusion that I might consider? What are the benefits of the alternatives? What are the risks?
• Will I be informed afterwards if I receive blood?
• Can I get a copy of my medical records?