The decline and fall of informed consent

Over at KevinMD there’s a great post by Richard Gunderman (Chancellor’s Professor, Indiana University) and James Lynch (Dean of Admissions, University of Florida College of Medicine). In the post they authors bemoan the fact that informed consent documents have become impenetrable aggregations of legalese in comprehensible to almost everyone.

However, the authors only hint at the most important point. Informed consent is the mutual understanding arrived at between two entities. Informed consent may be guided by the massive document to which the authors refer. The document may be used to memorialize the agreement. But, the document is not the agreement.

The authors refer to a 30+ page “informed consent” document for a cancer study. The average person would find the document entirely incomprehensible. But, the average person might actually sign the document because (s)he believes  that the study might offer improved opportunity for survival. The belief is frequently without merit.

Patient have a right to question the care they receive. In particular they should question experimental care. The most important thing any patient should realize-

The purpose of research is NOT to improve your health. The purpose of research is to advance medical knowledge and possibly the career of your physician.

Medical researchers have an irremediable conflict of interest and this conflict of interest will not be in the “informed consent” document. But this conflict of interest may well compromise your health and safety.

“People Will Die”

This is a common cry from politicians, the press, and consumers- especially in relation to the Affordable Care Act. The simple fact is that all of the “expected deaths” associated with losing “Obamacare” are going to happen anyway. Sorry but there’s nothing magic about having health insurance that endows an individual with immortality. Each and every one of those patients will die.

The better question, and the on no one wishes to address, is how much will an average person’s life be shortened by the loss of health insurance. It is absolutely true that health insurance is not the same as healthcare. Having an insurance you cannot afford to use is the same as not having insurance. Further, having an insurance that no provider will accept is essentially the same as having no insurance at all. In many ways an insurance policy no one accepts is worse than no insurance at all. If saddled with such a policy an individual has paid premiums but no may be subjected to uncontrolled out of pocket expenses to see a “non-participating” provider.

It’s time to move away from the rhetoric and start addressing the real issues of healthcare not the pseudo-issue of insurance. Insurance is merely doctor-speak for “pay me.”

This is a common cry from politicians, the press, and consumers- especially in relation to the Affordable Care Act. The simple fact is that all of the “expected deaths” associated with losing “Obamacare” are going to happen anyway. Sorry but there’s nothing magic about having health insurance that endows an individual with immortality. Each and every one of those patients will die.

The better question, and the on no one wishes to address, is how much will an average person’s life be shortened by the loss of health insurance. It is absolutely true that health insurance is not the same as healthcare. Having an insurance you cannot afford to use is the same as not having insurance. Further, having an insurance that no provider will accept is essentially the same as having no insurance at all. In many ways an insurance policy no one accepts is worse than no insurance at all. If saddled with such a policy an individual has paid premiums but no may be subjected to uncontrolled out of pocket expenses to see a “non-participating” provider.

It’s time to move away from the rhetoric and start addressing the real issues of healthcare not the pseudo-issue of insurance. Insurance is merely doctor-speak for “pay me.”

 

 

 

Welcome

American healthcare is complicated. Doctors are protected by state-sponsored monopolies and very high barriers to entry. This blog shall explore the intricacies of healthcare and help expose the dark side of healthcare for the average consumer.