Attitudes, Beliefs, and Practices of Aesthetic Plastic Surgeons Regarding Informed Consent

From informed to empowered consent

Informed consent is ethically incomplete and should be redefined as empowered consent. This essay challenges theoretical assumptions of the value of informed consent in light of substantial evidence of its failure in clinical practice and questions the continued emphasis on autonomy as the primary ethical justification for the practice of consent in health care. Human dignity-rather than autonomy-is advanced from a nursing ethics perspective as a preferred justification for consent practices in health care. The adequacy of an ethic of obligation (namely, principlism) as the dominant theoretical lens for recognising and responding to persistent problems in consent practices is also reconsidered. A feminist empowerment framework is adopted as an alternative ethical theory to principlism and is advanced as a more practical and complete lens for examining the concept and context of consent in health care. To accomplish this, the three leading conceptions of informed consent are overviewed, followed by a feminist critique to reveal practical problems with each of them. The need for a language change from informed to empowered consent is strongly considered. Implications for consent activities in clinical practice are reviewed with focused discussion on the need for greater role clarity for all involved in consent-beyond and inclusive of the patient-physician dyad, as the practice and improvement of consent is necessarily a transdisciplinary endeavour. Specific concrete and practical recommendations for leveraging nursing expertise in this space are presented. Perhaps what is most needed in the discourse and practice of consent in health care is nursing.

The importance of written informed consent in facial cosmetic surgery litigation

It is the aim of the study to discuss litigation related to facial cosmetic surgery with a particular focus on written consent, in order to prevent unfortunate outcomes for the surgeon and patient alike. A 10-year online search for facial cosmetic surgery litigation in Brazil was conducted from 2012 to 2022. Statistical analyzes were performed using RStudio, and the results were considered significant with a 95% confidence interval. A total of 992 litigations were identified through the search. Of these, 122 articles met our inclusion criteria. The number of legal disputes on this subject has been increasing for years. Female patients are more prone to litigation. Financial damage ranged from $75 to $500,000 (mean: $59,536). Many of the lawsuits that had appropriate written consent have had a favorable outcome for the defendant. The primary specialty was the most common plastic surgery (67%), followed by maxillofacial surgery (9%). Surgeons engaged in facial cosmetic surgery should protect themselves legally from litigation. Written consent significantly reduces both litigation losses and financial damage. Some details on the preparation of this consent form have been discussed.

The Anatomy of a Malpractice Lawsuit

Medical malpractice lawsuits can be a source of emotional, physical, and financial distress for both providers and patients. A thorough understanding of the medical malpractice process's history and current landscape will help providers navigate malpractice challenges. Given the impact and prevalence of medical malpractice, in this paper, the authors sought to dissect the intricate anatomy of a medical malpractice lawsuit. This includes a comprehensive and detailed report of tort reform, the criteria of a medical malpractice suit, and a description of the court proceedings. In addition, the authors also performed an extensive review of the medicolegal literature and have provided recommendations for healthcare providers to avoid these lawsuits in their practice.

Level of Evidence 5