Informed Consent is the Key to Saving Healthcare
by Rogier Fentener van Vlissingen | Nov 4, 2022 | Health, Politics,
Informed consent is the key to good medicine. The concept is present in everything from the Hippocratic tradition to the Nuremberg code and the WMA Helsinki Declaration on ethical principles in medical research involving human subjects. In the Covid crisis, we have just seen how all of these good intentions were forgotten at the drop of a hat in the panic over SARS-CoV-2. It was as if they never existed, with politicians playing MD all over.
The issue has perhaps surfaced most pointedly in Brook Jackson’s reports about the Pfizer Covid-vaccine trials when she observed that the informed consent was being effectively ignored and often incorrectly conducted, and certainly little or no adequate consultation with the trial participants took place. She names informed consent as the top violation she observed at Ventavia. But informed consent goes deeper than just filling out a form correctly or otherwise.
What Informed Consent should be ⏤ involves both the patient’s health status and the appropriateness of the product to them and their specific condition, including explaining the method of action of the proposed intervention and weighing the pros and cons, the benefits, and the risks. So it takes some time. A normal doctor-patient relationship should be a bonding moment between the patient and the doctor, where the patient can express their feelings and concerns and weigh the alternatives. At least mentally, you should do a T-chart if you think the proposed intervention makes sense to you based on your understanding of the method of action. Based on that analysis, you then decide whether to go ahead or not. That is the responsible minimum to satisfy the informed consent requirement.
It should be evident that the key elements here is an honest explanation of the method of action in lay terms and complete information about the possible side effects (adverse events). My own MD father always told me to change doctors if my doctor could not explain these things in understandable terms.
I would argue, however, that there is another, the much deeper rationale for this part of the process. I have argued elsewhere that medicine is on the verge of a significant change to recognize that the source of everything is in the mind and, therefore, that the mind, not the body is the locus of the first cause. It is really to the informed consent process that this part of the healing is addressed on the most pedestrian level. The informed consent conversation is the time of bonding between doctor and patient, and it establishes either a grown-up adult-adult conversation or a co-dependent parent-child communication, which we can immediately recognize with the basic principles of transactional analysis. This moment is actually a psychotherapeutic moment.
Psychotherapy is the only form of therapy there is. Since only the mind can be sick, only the mind can be healed. Only the mind is in need of healing. This does not appear to be the case, for the manifestations of this world seem real indeed. Psychotherapy is necessary so that an individual can begin to question their reality. Sometimes he is able to start to open his mind without formal help, but even then, it is always some change in his perception of interpersonal relationships that enables him to do so. Sometimes he needs a more structured, extended relationship with an “official” therapist. Either way, the task is the same; the patient must be helped to change his mind about the “reality” of illusions. (ACIM, P-in.1:1-8 – in: Psychotherapy: Purpose, Process, Practice, a supplement to A Course in Miracles)
If it is a mature conversation, doctor and patient realize that this is where they form a partnership about the healing, which has to provide a comfort zone in which both can drop their facade and address the healing process in such a way that the patient can be at ease with what he is about to undertake and why. The nature of this partnership is a collaboration of equals, in which the physician is the subject matter expert about the means of healing of the physical process of the disease, but the patient is also fully engaged in the treatment process as they are most in touch with their own body and have responsibility for the whole process.
If this communication is dysfunctional, and a co-dependent parent-child type communication, then all you have is the perfect setup for a medical malpractice lawsuit someday. If the doctor talks down to the patient, all the parent-child issues come into play, starting with dependency breeds contempt. Unfortunately, this is how it works many times, and our healthcare system encourages this by limiting the time of consults. Simply put, there’s never enough time to do it right the first time, but there’s always time to do it over, and, lest we forget, these are all billable events. The process is broken.
A proper informed consent process is, therefore, the single most important determinant of good outcomes, for it is about the mutual buy-in into the process of healing that is to be undertaken. The focus on symptom suppression in the allopathic model is almost certainly a determinant of bad outcomes, for it lends itself to defaulting to a dysfunctional therapeutic relationship.
In my own experience, I had moments like this with a doctor in the 80s when I had a problem with allergies. He wanted to prescribe Claritin; I asked him what it does do. When he explained it, I told him not to bother writing the prescription since all it did was suppress the symptoms. I found solutions with supplements, but later, I went on a whole food, plant-based diet, and I dropped those supplements again. That was the real solution. The decision to go that route in and of itself was made when another doctor suggested I was a candidate for a daily aspirin. I said no, I would go the diet route. I was already familiar with Dr. Esselstyn’s Prevent and Reverse Heart Disease, and I went home and read it a second time, and this time I got serious.
In other words, taking responsibility for your own health is absolutely the first issue. That decision places you, at least in principle, on equal footing with your doctor, where you are partners in healing, not a clueless patient expecting some magic from the expert doctor. And once again: if the doctor cannot handle communication “on the level” like that, lose him and find another doctor.
Rogier Fentener van Vlissingen is a Dutch native, living in America since 1979, in both Connecticut and New York. He has worked in international shipping and most recently he has mostly been involved in energy efficiency and retrofitting. He is also a co-founder of a biotech, BCM Industries, which develops autologous organ repair tissues, and also a line of revolutionary IT equipment, computers and storage appliances, running on live neurons. He is an eager student of business, literature, history and spiritual traditions. He also teaches whole foods, plant-based nutrition and cooking. He published his first book in Holland in 1973.
In 2007, Rogier published the book Closing the Circle: The Gospel of Thomas and A Course in Miracles. He blogs about energy retrofitting, energy finance, spirituality and whole-foods, plant-based
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