In Case You Haven't Heard…

Abstract

Our recent story on the need for informed consent (see Informed consent: Patients with OUD must be told about MAT, ADAW Sept. 27; https://onlinelibrary.wiley.com/doi/10.1002/adaw.33202) led to much interest, including from lawyers. One, a federal official speaking on background, noted this: State law requires medical professionals to only provide services they are competent to provide (e.g., an orthopedist is not competent or trained to perform brain surgery). Second, health and malpractice insurers set standards of practice that require medical professionals to make their patients aware of the risks and benefits of a particular procedure once it is recommended and chosen. “The trick is what the medical professional recommends,” our source said. “Informed consent really kicks in when a course of treatment is chosen, and it leads to the patient signing a document that states the risks and/or that the patient was made aware of the risks.” This is why many of us seek to find the “best” medical professionals, as they are usually the ones who will lay out all the options, versus only the one they prefer. In going to an opioid treatment program, for example, a patient will likely be offered medication only, not told to go elsewhere for abstinence‐based treatment. In going to a residential treatment center that doesn't provide medication, the patient will not be told to go elsewhere for another kind of treatment. This makes the addiction treatment field suspect in the minds of many consumers — and lawyers. This could be mitigated, of course, by informed consent — telling patients about other treatments and giving them the option of having them. Unfortunately, most patients seeking treatment for substance use disorder are in crisis and not able to go through this process.