Читать книгу Successful Training in Gastrointestinal Endoscopy - Группа авторов - Страница 48

In a few specific circumstances, a physician can bypass the need to acquire informed consent. Several important exemptions to informed consent include the following [3, 4]:

1 Emergency waiver: The patient's critical condition incapacitates them from providing informed consent, and delay in performing the procedure can result in unnecessary harm to the patient.

2 Waiver of self‐determination: A patient waives his/her right of informed disclosure and assigns his/her physician the right for decision‐making.

3 Legal mandate: A judge or court orders a necessary medical therapy for a patient without their consent.

4 Incompetence: A patient cannot make a decision and thus this responsibility is given to an assigned third party (legal guardian).

5 Therapeutic privilege: A physician can withhold information regarding the procedure because of perceived harm to the patient. This is a difficult exception and one that can be perceived as an excuse for not informing the patient. Unless there is a clear and compelling evidence of psychological vulnerability, it is best to avoid use of this exception.