This is related to all medical practice not just Lyme borreliosis. We have inserted our comments.
“Patients have the right to decide on investigations and treatments (patient autonomy).”
Properly informing the patient (captured from Canadian Medical Protective Association June 18th, 2018)
Canadian legal judgments dealing with informed consent suggest the following interpretations:
- When possible inform the patient of the diagnosis. If some uncertainty exists about the diagnosis mention this uncertainty, the reason for it, and what other possibilities are being considered (CanLyme Note: Lyme borreliosis is seldom considered outside of current poor testing protocols that yield a high rate of false negatives).
- Explain the proposed investigations or treatments (CanLyme Note: fear mongering about the use of longer term antibiotic therapy is a common practice used to dissuade appropriate treatment of chronic Lyme borreliosis even while longer term antibiotic therapy is used for many other illnesses. Chronic Lyme borreliosis patients face institutionalized discrimination, not evidence based but certainly profitable for the larger global pharma industry… ie. a new drug for every symptom (while not addressing the disease), global disability insurers denying the existence of chronic Lyme (whose investors and board members often direct profitable drug research of the drug companies) – claim denied, unnecessary knee and hip replacements, universities’ never ending feeding at the trough of our tax payer funded vaccine research programs, not-for-profit ‘disease’ societies whose leadership receive ridiculous salaries.).
- Indicate the chances of success.
- Inform the patient about available alternative treatments and their risks. There is no obligation to discuss what might be clearly regarded as unconventional therapy, but patients should know there are other accepted alternatives (black bolded by CanLyme) and why the recommended therapy has been chosen.
- Inform the patient about the consequences of leaving the medical condition untreated (CanLyme Note: permanent disability, subsequent improper diagnosis, subsequent improper dangerous treatments, loss of career, loss of financial stability, loss of marriage, loss of life).
The courts have been quite clear that physicians are expected to answer patients’ questions as honestly and completely as they can.
Material and special risks
- Material risks include risks that occur frequently as well as those that are very serious, such as death or permanent disability (CanLyme Note: a serious concern with a false negative Lyme test and failure to consider other tick borne diseases or toxins).
- A patient’s special circumstances might require discussion of potential but normally uncommon risks of the investigation or treatment, when typically these might not be seen as material.
- The courts have been clear that the consent discussion extends to what the physician knows or should know (black bolded by CanLyme, this is 2018, this is not a new disease, they should know yet are not taught but physicians cannot sit back and, simply follow disputed guidelines and education ‘widely known’ to be in question) a particular patient would deem relevant to making a decision about whether or not to undergo treatment.