In Australia, all medical treatment must be preceded by the patient's (or a substitute decision-maker's) consent, except in cases of emergency or necessity.
Consent to treatment is valid if the patient or decision-maker has capacity and gives their consent voluntarily once they have been informed in broad terms of the nature of the treatment. Treating a patient without consent could result in legal action against a health professional for battery or assault.
The term ‘informed consent' means a ‘person's voluntary decision about medical care that is made with knowledge and understanding of the benefits and risks involved'. The purpose of informed consent, also referred to as ‘informed decision-making', is to enable patients to make decisions about their treatment based on an adequate understanding of their illness and available treatment options.
Informed financial consent is an important related concept. Informed financial consent refers to the expectation that patients should be fully informed about medical costs prior to commencing a procedure or treatment, or committing to a treatment path that may involve ongoing costs. This allows patients to factor in any out-of-pocket costs (those not covered by Medicare or private health insurance) when deciding which tests or treatments to undertake.
Informed consent, including informed financial consent, is a fundamental element of cancer treatment and care, and there are strict legal and professional obligations for medical practitioners to ensure their patient is making an informed decision. A cancer patient who is not properly informed about the nature of a treatment may experience negative medical and/or financial outcomes, and, may have chosen a different treatment path if fully aware of the benefits and risks of available treatment options and associated out-of-pocket costs.
Making the law work better for people affected by cancer: report findings
- Although the law of consent to medical treatment is well established, the application of the law in practice, and adherence to professional guidelines, may not be consistent.
- Feedback from our survey and focus groups indicated that while most Victorian cancer patients felt that they were able to make an informed decision about their treatment, many patients felt that they did not receive enough relevant information about specific areas that are required by law and the professional guidelines to be communicated - including information on potential side-effects or complications - and some did not feel that overall they were able to make an informed decision about treatment.
- Barriers to informed consent included patients feeling overwhelmed and in shock from their cancer diagnosis, a perceived lack of time for consultations, and the speed at which some patients progress from receiving a diagnosis to treatment.
- While the principles of informed financial consent, as reflected in professional guidelines, encompass the responsibility of medical practitioners to communicate the potential costs of medical treatment options, feedback from survey participants and focus group attendees echoed findings in other reports, which indicate that many cancer patients are concerned about the unexpected costs of cancer treatment, including out-of-pocket medical costs.
- Greater consistency in informed consent processes is required within the medical profession.
- Further education or training to improve doctors' knowledge of the purpose of informed consent processes, their professional obligations and best practice in the provision of information to patients.
- Better mechanisms to ensure patients are fully informed about treatment costs.
- Support for doctors to discuss non-medical costs, such as travel and accommodation expenses, with their patients, especially those that may be relevant to the patient's treatment decision.