Page 74 - Athletic Health Handbook
P. 74
tency in the consent process in that specialists. The referring physician programs, and to provide other rele-
each patient receives the same written must stress the risks of not seeking vant information. However, the physi-
information. Requiring patients to the additional testing or treatment cian should spend some time with the
read and sign a consent form also and take reasonable steps to determine athlete to make sure the patient fully
focuses the patient’s attention on the whether the patient has followed the understands the risk of the procedure
information being provided and thus physician’s advice. A patient’s decision and has received satisfactory answers
helps to ensure that consent obtained to forgo treatment should be fully to all of his or her questions.
is truly informed. documented in the medical record.
Playing Against Medical Advice
Can too much information be Does the consent form substitute
provided? As noted above, the patient for face-to-face discussions? No. The A closely-related issue to the need
should be informed about all of the information in the form must be for informed consent arises when an
material risks and benefits or the carefully explained to the patient. athlete decides to participate in his or
procedure, as well as any reasonable This is true even if the team uses her sport against the team physician’s
alternatives. The provision of too electronic aids, such as a video or advice. In these circumstances, the
much detail could easily obscure the online explanation of the procedure physician should make sure the athlete
patient’s ability to understand and with follow-up questions and answers. is fully informed about the risks and
appreciate the critical information These tools can greatly enhance the possible consequences of playing while
necessary to make a reasonable deci- consent process by providing patients hurt. The team, the coaches, and
sion. Striking this balance between with a better understanding of the the team physician would all be
providing too little information and procedure to be performed. However, well-advised to have the player sign a
providing too much is a difficult but they cannot substitute for face-to- combined assumption of risk/waiver
essential task for the physician and face discussions with the physician and release form as a condition of
his or her staff. and his or her staff.3 being allowed to participate.4

What is the physician’s obligation Does the physician have to This form is different from a
when a patient refuses treatment? personally discuss the risks and consent form, which applies only
The courts have made it clear that benefits of the procedure with the to the provision or withholding of
a physician has a duty to inform patient? Yes. The physician should treatment. By contrast, the assumption
patients of the material risks of refusing participate in some phase of these of risk/waiver and release (a) informs
a procedure, particularly if the patient discussions. A trainer, nurse, or other the player of all the risks of partici-
has declined a risk-free test, like an staff member may be present initially pating in a particular sport in the
EKG, or a potentially life-saving to explain the consent form, to player’s current condition, (b) states
procedure, like a blood transfusion. provide instructions regarding the that the team physician advises him
This rule also applies to referrals to use of videos or interactive software against playing, and (c) requires the

THE TEAM PHYSICIAN AND LEGAL ASPECTS OF INFORMED CONSENT 74
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