Consent the Most Important Statement

Consent

The most important statement included in the NCCAOM related to the practice of Traditional Chinese medicine is the statement referring to the obligation of "keeping the patient informed by explaining treatments and outcomes." This statement is basically valid in any treatment, but, given the fact that traditional Chinese medicine is less of a custom in Western treatment, it is thus even more in this particular case.

The patient needs to have explanations, first of all, on the meanings of Chinese medicine, on the principles it is based upon. These will help him understand why acupuncture can be helpful in delivering certain illnesses and how a general equilibrium can be reached in the body. Further more, the patient needs to be fully informed on the expected outcome and be convinced that this is a long-term process rather than a quick recovery.

On the other hand, issue #5 from the basic principles of the AMA makes reference to similar ideas. The physician not only has the duty to inform, but to remain continuously informed by a continuous research in any medical segments, including the Traditional Chinese medicine.

Finally, the AOM Code of ethics makes again clear reference to the necessity of constantly informing the patient about the techniques used and the potential outcome.

2. The two main problems that generally may appear are related to (1) obtaining consent and (2) communicating consent and information. In the first case, the patients may be physically unable to give consent, because of the physical condition they are in. In this case, it is generally up to the closest relatives to do so, but what happens if we are not 100% sure that they are most likely to have the patient's best interest at heart? In other cases, religious and cultural barriers may lead the patient or the family to refuse a certain necessary medical treatment (Jehovah's Witnesses, for example, are known to refuse medical treatment and operations of any kind). The ethical dilemma that occurs here is related to the necessity of doing the right procedure, but with the reluctance of the patient to provide consent for it.

In the second case, communicating consent and information can be made difficult by language or cultural barriers. The ethical dilemma relates to whether or not the patient properly understands what he is up against and whether he is able to make an informed decision.

3. With traditional medicine, there is a problem of communication and understanding. The Western patients are not used to TCM, it is something new for them, so a lot of time needs to be spent in delivering the appropriate information in terms of principles and practice before anything can actually be done. If this was applied in China, many of the steps could be skipped, because many of the principles are related to Chinese spiritual practice.