What Constitutes a Dental Treatment Consent Form?
A Dental Consent Form is a written document provided by a dentist to a patient in order to ensure that the proposed treatment has been adequately defined, and that the risks and benefits of the treatment have been fully explained to the patient. It is a comprehensive document that outlines the type of treatment planned and any alternatives to that treatment. The patient will sign the consent form at least 24 hours in advance of the proposed treatment. The Consent Form will also notify the patient that he/she has the right to refuse treatment and may revoke consent at any time before the treatment begins. It will generally include a statement advising the patient that the form constitutes the entire agreement between the parties, that no oral representations have been made to induce the patient to sign the Consent Form, and that such Consent Form may be expressly revoked in writing . The Consent Form is of extreme importance as it amounts to a binding contract whereby a patient grants permission for a proposed surgical or dental procedure after being fully informed about the procedure. The purpose of the Consent Form is to ensure that the dentist explains the procedure to be followed and the associated risks to the patient. If the patient has not been fully informed about the procedure, the Consent Form will be rendered meaningless. If, however, the dentist can show that the patient was fully informed, the patient will be bound by all of the terms and conditions of the Consent Form.
Essentials of a Dental Treatment Consent Form
A dental consent form is a standard part of treatment at a dental practice and can cover a single treatment method or multiple procedures that are prescribed to one patient. The primary use of the form is to demonstrate that the patient has freely granted permission to undergo the procedure. While whether or not proper consent was given is often a key issue in malpractice cases, a consent form does not establish an absolute defense to such lawsuits through proving consent was given. As long as the dentist can prove that they gave reasonable disclosure of the potential risks and concerns related to the procedure, then having permission is likely sufficient.
Regardless of how broadly or narrowly it is written to address a single treatment or a wide range of procedures, the consent form will generally include the following components: A patient’s information The type of treatment being requested The potential risks and benefits of the treatment The potential risks and benefits of alternative treatments The patient’s acknowledgment of the information provided in the consent form.
The Legal Aspects and Regulatory Standards
The legal requirements governing dental consent forms vary from state to state and country to country. Generally, informed consent involves making sure a patient is aware of the consequences of a treatment or procedure, including any potential risks. However, jurisdictions differ in how formal and detailed a properly informed consent must be for it to be considered legally valid. In addition, while written dental consent may be formally required, in practice, there are numerous ways that a well-informed patient may give consent. In many states, federal law mandates an informed consent process as part of its regulations. Federally recognized tribes may also mandate an informed consent regulation in order to receive federal funding through the Indian Health Service. Essentially, if a dental practice takes the form of a state-funded program or federally recognized tribe receiving federal funds, the dental practice may be subject to such laws. Beyond informed consent being legally required, it is essential for best practices in the pursuit of making sure each patient knows the risks of treatment.
The Importance of Consent Forms for Patient Confidence
When patients enter into relationships with their dentists, they do so with the intention of receiving the best treatment possible in a professional and trustworthy environment. Dentists likewise enter these relationships, equipped with the intent of providing their patients with effective treatment options, and having their patients trust in these options as the most effective methods of care.
As a matter of course, trust is required for proper treatment. Patients must trust that their condition or injury is accurately disclosed and described; they must trust that the methods of treatment and areas of potential complications are accurately described to them; they must trust that the dentist will genuinely attempt to make all reasonable efforts in carrying out the treatment of the patient. The last point, in some cases, may require a certain degree of implied assumption of fault for treatment that ultimately fails or results in injury; dental treatment is not guaranteed to succeed, and dentists are not equipment manufacturers, whose products are known to be equal in uniformity and reliability. In other words, mistakes can be made by even the most competent and experienced dentists, and this is fully understood by patients.
This is commonly explained by dental consent forms. Because of the very nature of dental care, and the average level of trust patients have in their dentists, consent forms become necessary to ensure that patients are fully aware of the unavoidable limitations of treatment. This ensures that patients will not be disappointed with the outcome of an otherwise successful dental procedure simply because it falls below a certain level of excellence.
Proper Documentation of Consent
It is vitally important that the consent process be properly documented, and this should be done as follows:
- A proper record should be made, often to the extent of contemporaneous entries being made in the patient’s clinical record. The better the practice systems and procedures, the higher the level of documentation likely will be.
- However, a free-standing document recording the consent process also can be of great assistance to the practitioner in this regard, particularly for treatments requiring general anaesthesia or sedation.
- That recording should include statements to the patient and other appropriate information such that patients are afforded the opportunity to make informed choices. It also should provide an appraisal of the whole treatment process.
- In addition, the patient should be invited to ask questions and will be encouraged to seek additional information should this be required .
- If there are any significant developments during the course of an appointment, which could affect either: a) the likelihood of success; or b) the risks/complications associated with the treatment, the dentist should ensure that such matters are disclosed and comprehensively explained.
- This may mean that a process of re-consent should occur; particularly in relation to a surgical procedure or similar. Such a process would involve the patient being afforded an appropriate opportunity to consider whether or not to proceed with the procedure, based upon the additional information provided.
- In addition, it is good practice to ensure that an invitation is given to the patient to request a second opinion in relation to the treatment process.
- The patient’s signature should be sought in appropriate circumstances reflecting such matters as: the nature and the totality of the treatment to be provided; the appointment period(s); the payment amount(s); the payment terms; and any other pertinent particulars.
It is not sufficient simply to provide the patient with another dental treatment plan form or treatment estimate for this purpose.
Pitfalls and Prevention Strategies
One of the most common errors across all forms of informed consent, including dental consent forms, is the doctor signing the patient’s name after the patient has signed the form. This error is particularly problematic as it eliminates any evidence that the patient personally signed the document. The documents should have signature lines for both doctor and patient, with the patient signing first and the doctor signing second.
Also avoid crossing out anything on the form, even to correct a mistake in handwriting. All changes or alterations should be made on a separate addendum to the consent form, and duly signed and dated by all parties. The most frequently crossed out items are those relating to acknowledgement of risk, cost of treatment, and agreement to pay. Sometimes some of this information is omitted inadvertently, or overlooked by the doctor or office staff. Crossed out items will invariably be seized upon by plaintiffs in any malpractice cases arising out of treatment of a patient who has signed an informed consent form with any crossed out language. Any information you believe to be material or discretionary must be discussed with the patient and added to a fully completed consent form before treatment begins. For example, before performing routine dental work, the dentist should ask the patient whether he or she has any allergies, is taking any medications and has any health issues. If a patient has ever experienced unusual adverse reactions to anesthesia or bleeding with dental treatment, the dentist should ensure that that information is incorporated into the consent form. Similarly, it is not enough just to hit the highlights in the patient’s file or health history. A thorough review of the patient’s medical history, noting allergies, medications, health issues and other relevant information relating to possible complications of anesthesia is essential to fully documenting the patient’s medical condition for purposes of informed consent. The associated consent form for the anesthesia should address any adverse reactions the patient has had to anesthesia in the past, and any medical treatment the patient has had to undergo as a result thereof. In addition to omissions, other common errors in informed consent forms include incomplete forms. All blanks, checklists and other areas of the consent form must be complete and accurate. A blank space may provide an opening for a patient’s attorney to argue that the information was discussed, but not disclosed to the patient prior to consent because it was not included on the informed consent form. Fixing incomplete forms means contacting the patient to have him or her sign an addendum to the consent form. In the event of a disputed consent at trial, if the Consent Form contains any incomplete form or missing information, the Plaintiff will highlight deficiencies and failure to disclose all information that was required under the circumstances. Remember, informed consent forms are a record of the exchange of important information about a patient’s condition and the risks and benefits of treatment. If you fail to communicate necessary information, and to document your communication with the patient in a comprehensive informed consent form, you risk having the consent be deemed invalid. In any consent form, the risk of a plaintiff’s attorney seizing upon any error, omission or incompleteness to argue in retrospect that consent was not fully informed and could not have been valid, weighs heavily in favor of careful completion of all forms.
The Pros and Cons of Electronic Consent Forms
In recent years, there has been a noticeable shift towards the use of digital consent forms within the dental industry. This shift has been driven primarily by advancements in technology and software that allow for a streamlined and efficient process for both dentists and their patients. Digital consent forms are easy to implement, can be accessed from any device with internet connectivity, and provide a more organized system for documenting patient consent.
One of the primary advantages of digital consent forms is that they can be easily stored and organized within practice management software. This allows for easy storage and retrieval of patient documents, including consent forms. Digital forms can also be easily updated and edited as needed, eliminating the need for physical copies that can become outdated over time. Additionally, digital forms can be easily shared with multiple members of a dental team, allowing for more efficient record-keeping and communication.
For patients, digital consent forms can increase the ease of reading and signing necessary forms. Patients can e-sign their consent forms directly on their devices , negating the struggles with deciphering handwriting on paper forms. Digital consent forms may also be easily read on a computer screen, which can make it easier for patients to understand the potential risks and benefits associated with their treatment. In turn, this may lead to fewer misunderstandings or disputes over consent.
However, there are also some potential downsides to digital consent forms. Not all patients may have access to the necessary technology or be comfortable using a digital device to sign documents. Additionally, digital consent forms may not be as easily accessible to dental teams if practice management software is not set up to share documents among team members. In addition, there is a concern for the security and confidentiality of patient information. Steps must be taken by a dental team to ensure that any digital records – including consent forms – are accessible only to authorized personnel, in order to protect patient privacy.
Dentists who choose to use digital consent forms will want to do their research and invest in durable, secure, and reliable software that fits their practice’s needs. It is important to evaluate a software’s security features, customer service options, and ease of use.
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