Endodontists, like all health care providers, are legally required to obtain a patient’s informed consent before performing a procedure. Informed consent is governed by state law; your state dental association is the best source of specific information. The AAE also recommends that members consult with their professional liability carrier for specific guidance, including sample forms. The AAE provides this information as general background. It is not a substitute for legal counsel.
To obtain informed consent of the patient, the endodontist must personally, in a face-to-face conversation, disclose the following information in language that is understandable to a lay person:
- The diagnosis
- Nature of the proposed treatment or procedure
- Risks reasonably associated with the proposed treatment or procedure
- Prognosis after the proposed treatment or procedure
- Feasible alternatives to the proposed treatment or procedure
- Risks associated with declining treatment. “No treatment” is an alternative.
The endodontist also must provide an opportunity for the patient and/or the patient’s guardian to ask questions about any of the above.
A patient cannot provide informed consent if he/she is unable to understand the information given and is not represented by a guardian. Examples include, but are not limited to, patients with limited English proficiency, hearing impaired, or elderly individuals with diminished capacity.
The written consent form, with the patient’s signature, documents that the endodontist discussed the procedure, risks, prognosis and alternatives. A written consent form is not a substitute for the endodontist’s in-person discussion with the patient. Because of the range of endodontic procedures performed and the variances in state law, there is not a “one size fits all” consent form. Although not necessarily a legal requirement, some forms require the provider’s signature, and/or a witness to attest that the validity of the patient’s signature. In some states, a notation that consent was obtained may be required in the medical/dental record.
A thoughtful, well-documented dialogue between the endodontist and the patient can reduce misunderstandings and incidence of claims and suits alleging a lack of informed consent.