24
Treatment
Table 4. Informed Consent Checklist
The three components of informed consent involve:
• Disclosure • Decision-Making Capacity • Voluntariness
Disclosure:
• Truthful prognostication
• Treatment options available and all associated side-effects, ranging from aggressive
treatment to palliative care and hospice, including the option of medical assistance in
dying.
Consent for Treatment
Discuss Advance Directives, code status, and naming a surrogate decision maker.
• Surgical Management
▶ Surgical candidacy and expected benefits and risks
▶ Discussion of intubation and tracheostomy
• Drug Therapies
▶ Candidacy and contraindications
▶ Costs and expected benefit ratio
▶ Expected and rare side-effects
▶ When to stop the drug if risks outweigh benefits
• External Beam Radiation
▶ Candidacy and contraindications
▶ All side-effects and palliation of side-effects
▶ When to stop radiation if risks outweigh benefits
Decision-making capacity:
a
• After the disclosure discussion, do a "teach back" with the following questions to
assess Understanding (U), Appreciation (A), Rationality (R), and ability to Express a
choice (E) (U-ARE)
▶ What do you understand about your situation?
▶ What are your treatment options?
▶ What will happen when you take/do not take this treatment?
▶ Why do you want/not want it?
▶ What other choices do you have?
▶ How did you arrive at your choice?
▶ What questions do you have?
▶ What are you worried about?
