Informed Consent – Giving the power back to the patient

In Ontario, as in most Canadian jurisdictions, the patient has the power to choose from whom they wish to receive their health care treatment. However, once they make that choice, the power dynamic reverts to the health professional.

It is well known that in every practitioner/patient relationship, there is a power dynamic that favours the practitioner. To be clear, the patient has a need and they visit a naturopath to seek health services. They rely on the naturopath to have all of the answers, guide them in their decisions, and perform treatment to improve their health. They simply want to feel better.

This College, like most of its counterparts, has clear and important standards and guidelines on what informed consent means. There is, however, a simpler approach to the contemplation of this issue. Informed consent is about giving the power back to the patient.

No patient should feel obligated to accept treatments with which they are unfamiliar and uncertain. The power of choice is about choosing your practitioner and choosing your treatment. A naturopath can easily comply with the informed consent requirements by simply providing the patient with all of the information they need to make an informed choice.

What is needed to make an informed choice?  It begins with the diagnosis, “what’s wrong with me?” in the patient’s eyes. It carries forward with

  • the treatments available from the naturopath and what that treatment entails, i.e. what the treatment plan looks like to the patient,
  • the likelihood of success of the treatment,
  • the treatments available from other health care providers,
  • the risks inherent in the treatment,
  • the risks of not seeking any treatment,
  • the impact the treatment is likely to have on the patient during treatment,
  • what the patient should or should not do during treatment and,
  • the costs of the treatment and any required medications/supplements.

Finally, and perhaps the most important element of informed consent, is the concept that consent must be freely given, and that it can be withdrawn at any time. The environment in which consent is discussed must be free of pressure to make one choice over another, including the choice to seek naturopathic treatment or not, and it must be a discussion between equals. There is no power differential among equals and there should be no power differential between naturopath and patient.

So the next time you are speaking with a patient about naturopathic care and treatment, ask yourself this, do they have the power or do you?