Informed consent



Informed consent is consent given by a patient to undergo a medical or surgical treatment or to participate in an experiment after the patient understands the risks involved. Obtaining informed consent from patients before medical treatment is performed has long been viewed as a doctrine of medical ethics. Under English common law, providing treatment without consent was considered a form of battery. In 1978 the US Congress formed a Commission of experts to study “the ethical and legal implications of the requirements for informed consent." It concluded that informed consent rests on three closely interrelated elements: patients must possess the capacity to make decisions about their care; their participation in these decisions must be voluntary; and they must be provided adequate and appropriate information to make the decisions before them. The Commission concluded that "a choice that has been coerced, or that resulted from serious manipulation of a person's ability to make an intelligent and informed decision, is not … the person's own free choice." They summarized that the key elements of the disclosure required by physicians include the nature, risks and benefits of the procedure, as well as the availability of alternatives.

One of the most questionable practices associated with the abortion industry is its failure to obtained adequate "informed consent". With any other form of surgery the doctor is required to explain to the patient the details of the procedure and the risks involved. Only after being given such information can the patient give "informed consent". Given that this procedure involves a mother terminating the life of her child both psychological and physical risks are very substantial. But very little factual information is given, and the the risks are often ignored or rarely given verbally as is customary with other forms of medical care.

In their book "Women's Health After Abortion, Ring-Cassidy and Gentles state:" In the context of abortion, the likelihood of uninformed consent is very real. Aside from the natural reluctance of abortion doctors to disclose their true immediate surgical complication rate, these practitioners are not in a position to outline medium- or longer-term complications of the procedure, even if they were inclined to do so. Private abortion clinics do not provide after-hours care, or any form of higher-level care for complications such as excessive bleeding, uterine perforation, or systemic infection. Moreover, abortion doctors are unlikely ever to learn of later sequelae such as infertility, life-threatening ectopic pregnancy, subsequent birth prematurity (with its high rate of cerebral palsy), or the late complications of any needed blood transfusions. Nor are they trained to weigh the risks of non-gynecological complications such as breast cancer or depression.

All US states require that health care providers obtain consent from patients prior to performing medical procedures, but as of 2007 only 33 states have laws specifically related to informed consent for abortion – often called "Right to Know" laws. These states require that verbal information be given on the procedure and the gestational age of the fetus, but only 23 states mandate that patients are provided with descriptions of the developmental state of the fetus. Some states, such as Michigan have elected to provide these documents at least 24 hours prior to the abortion procedure. This is done to provide a cooling-off period, and give the mother time to think sufficiently about the decision.

With ultrasound technology now in common use, many argue that a mandate should be in place for abortion clinics to provide these services to clients as part of their informed consent criteria. It has been found that the majority of women considering abortion decide against the procedure after counseling and viewing an ultrasound. The Options Pregnancy Resource Centers in Oregon reports that as many as 45% fewer women have abortions after viewing ultrasound images. Focus on the Family, which grants ultrasound equipment to qualifying medical clinics through their Option Ultrasound™ Program, states that 120,000 babies have been saved by the use of ultrasound technology since their program's inception in 2004. That women choose against abortion after viewing these images helps to strengthen the argument that they were not adequately informed to give consent prior to the sonography.

However, as of 2007 only 5 US states provided information on how to obtain ultrasound services, and only 3 required that one actually be performed and viewed.(see table). However, many states are now considering passing this type of legislature. On March 2012 the Idaho Senate passed Senate Bill 1387 which would require an ultrasound prior to performance of an abortion. It would also require that the woman sign a form indicating that she had been given an opportunity to view the image. On March 19, 2012 Virginia Governor Bob McDonnell signed into law a pro-life bill that allows women in Virginia to see the results of an ultrasound that is routinely performed by abortion facilities prior to an abortion. Seven other states also now have laws that require an ultrasound for each abortion and require that the patient is provided an opportunity to view the image: Alabama, Arizona, Florida, Louisiana, North Carolina, Oklahoma and Mississippi.

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