Patient “Informed Consent”…or Lack Thereof

Hello bOObs Bloggettes:

Today we’ll look at what’s called “Informed Consent,” which is to be given prior to a patient’s medical treatment. This consent is our legal right as a patient and should never be overlooked by practitioners — but often it is. Here’s what’s going on:

I interviewed for my film “bOObs” a former state attorney general, who lamented that Informed Consent for patients’ medical procedures is often lacking. Patients are supposed to receive all the information about a diagnostic procedure or any medical treatment prior to carrying it out. If we’re not given all the information — good or bad — how can we make a sound decision for treatment?

Unfortunately, sometimes even the physician doesn’t have all of the information or, worse, they have been given the incorrect information by some other medical authority towering above them — including their trade associations.

I discovered this by reading what association heads were telling their members (a lot of it is hidden in plain sight on their websites) and how it conflicted with what was in the medical literature.

Specifically with regards to breast cancer screening and as one example, women aren’t given the correct information about radiation amounts in mammograms. We’re told that it’s the “same radiation amount as flying across the U.S.” when we ask our doctors (see my prior blog on this) — but they are referring to scattered radiation from the mammogram versus direct absorbed radiation to the breast which can give us cancer years later. Yet the doctors don’t realize this. This is a sound bite that’s been given to them in med school, repeated by fellow colleagues, and/or regurgitated by their associations. It’s really laughable and, unfortunately, sad for us patients.

And that’s just for starters. If you have dense breast tissue (90% of us do), after squishing your breast to the size of a French crepe, the radiation technician goes behind his/her leaded shield and starts cranking up the radiation so that the radiologist can later differentiate between the dense tissue and cancer (both appear white on a mammogram; see previous blog) — but they don’t tell us this first!

By my calculations in taking everything into consideration, the radiation we’re actually receiving from a mammogram can be up to 20 times more  than the scattered radiation amount they use in their “flying plane” metaphor. And some dense breasted women are getting up to seven times the amount of radiation over the “industry standard” amount in just a single view — but they don’t tell us this first!

Hence? A patient’s Informed Consent is lacking in breast cancer screening. Plain and simple.

In the words of Grant Woods, former AZ state attorney general, “If the patient doesn’t have all the information that the patient should have to make an informed decision, that’s just flat wrong.” When I asked him to expound on the legal implications, Mr. Woods said, “I don’t know if it’s criminally illegal, but does it break the Consumer Protection Laws ultimately? Probably does, yeah.”

I’ll elaborate in an upcoming blog on the different sets of information used by radiologists vs. gynecologists vs. radiation physicists and how that affects the patient’s Informed Consent. I’ll also describe a personal medical situation I encountered in this area, which ended in a comedy of errors.

The bottom line is this: A woman should  have the right to decide on which screening test to receive based on correct information given to her by her doctor before screening. We should be informed of all the pros and cons of these devices so that we can make up our own minds, weighing out the risks vs. benefits.

Blog at you soon, thanks for reading and helping to spread the word! (Please see the “share” links below).

Stay healthy,

Megan

Megan Smith, M.S.
Director, bOObs: The War on Women’s Breasts

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