Real informed consent is tough

In one of my small groups yesterday, we talked about how hard doing a good informed consent really is. If you have to consent someone of low medical literacy of a few different things at the same time, do you ever walking away feeling that they truly understood all the benefits but also the risks and potential adverse outcomes? Do they really understand the likelihood of getting an infection after a central line is placed, or do they think we just have to say these things?

We have trained years and years to fully understand the procedures and potential outcomes. Yet we expect someone with potentially no medical background, or worse, previous misinformation about the healthcare system to understand the differences and dangers of intubating, central lines, chest tubes, ventilators, and antibiotics in one ICU informed consent. I have a hard time believing, anyone would not be saturated within the first few minutes of such a conversation.

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