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Health Care Providers
Consent for Medical Care
To give consent for medical care, patients must be able to understand and make reasoned decisions regarding the nature and consequences of the medical intervention, the proposed treatment, and alternatives to treatment.14
Patients should be able to weigh the risks and benefits of different treatments and fully understand their evidence collection options. Health care providers need to have policies in place to address consent when patients are permanently incompetent (e.g., intellectual disability, irreversible dementia) or temporarily incompetent (e.g., unconscious, intoxicated, under the influence of drugs, injured) to give consent. These policies are best developed in conjunction with advocacy organizations, law enforcement agencies, district attorney's offices, forensic examiner programs, and hospital administrators, when applicable.15
If a patient gives consent or refuses to do so when competent, that decision applies even if the patient later becomes incompetent. Obtaining evidence without appropriate consent could subject examiners or hospitals to legal liability.16
There are two essential but separate consent processes—one for medical evaluation and treatment and another for the forensic exam and evidence collection. Victims should understand the full nature of their consent for each procedure and whether it is for medical care or evidence collection. Forensic medical examiners need to inform patients of their options, including the consequences of their decisions, without being judgmental or overly coercive (e.g., victims should not feel guilty or shameful). When seeking consent, health care personnel must be sure that any information given to patients is complete, clear, concise, and tailored to their communication skill levels. They also should be aware of verbal and nonverbal cues from patients and adjust their methods of seeking consent to meet patients' specific needs.
Consent is typically given for the following:17
- General medical care.
- Pregnancy testing and reproductive health care.
- Testing and prophylaxis for sexually transmitted infections.
- HIV prophylaxis.
- Permission to follow up with the patient for medical purposes.
- Release of medical information.