Ethical Issues

The Wednesday AccrualNet Post (5-15-2013): Consents, Communication, and Common Sense

Last Updated: May 15, 2013

This week's blog post continues our May theme of Informed Consent.

Linda Parreco's Image

We hope that you're enjoying the Informed Consent theme on AccrualNet this month. We kicked off the month with Sona's tips for finding great resources in AccrualNet to support your informed consent process. Last week Ellen provided a fabulous checklist to help you avoid the 'Top 12 Informed Consent Dings'.

Today I spent a wonderful hour listening to Lidia Shapira, MD, on the webinar, 'Enhancing Communication During the Informed Consent Process'. I first encountered Dr. Shapira, a medical oncologist at the Gillette Center for Breast Oncology at Mass General and Assistant Professor of Medicine at Harvard Medical School, at the 2010 NCI/ASCO Clinical Trials Accrual Symposium. I don't know Dr. Shapira personally, but I've been a fan since then. In addition to her experience and knowledge in the area of communication and consent, two things really made an impression: Dr. Shapira's gentle demeanor and her common sense observations and approach to informed consent discussions with patients.

Dr. Shapira's 9-step 'Vision of an Ideal Consultation' is a blend of science, communication and common sense:

Step 1: Establish a framework for deliberation

Step 2: Define mutual goals

Step 3: Present treatment options, standard first

Step 4: Address uncertainty, risks and benefits

Step 5: Stress voluntary nature and don't 'hard sell' the trial

Step 6: Explain randomization

Step 7: Explore beliefs and lifestyle; clarify and check understanding

Step 8: Allow time to introduce the research nurse; provide printed materials

Step 9: Support decision and obtain consent for treatment

Maybe you'll consider incorporating this approach into your practice. Do you use a similar--or different--approach?

Incidentally, Lidia was our first AccrualNet Guest Expert blogger--you can read her post here. You might also be interested in her Medscape Connect Blog, "Patients, Practice, and Personal Care."

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