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correspondence

Indian Pediatr 2011;48: 659

Informed Consent in Pediatric Practice


We read the article "Informed Consent in Pediatric Practice" in a recent issue with interest, and to get legal insight [1]. The article mentions that "The process of informed consent in pediatric patients is not well understood". If authors say in the abstract that they have not understood process of "informed consent in pediatric practice" then whatever is written in article is of no value to reader. It is a contradictory statement made with respect to the title.

Pediatric emergencies are common and form a large section of patients in nursing home/hospital or institutional practice. The authors are silent about informed consent in emergency situations in pediatrics. They have also not touched upon an integral part of informed consent i.e. patient confidentiality, and finished the review on informed consent. Authors have also stated that a ‘general consent’ for treatment is obtained for physical examination, basic investigations and prescription of standard medications. We are sure there is no need to obtain such a general consent under any Indian law since it is covered under implied consent. The authors have also missed the rich resource enlightening the process and nature of informed consent in decided Indian case laws.

Mahesh S Baldwa and Namita M Baldwa,
Baldwa Hospital, Mumbai, Maharashtra, India.
Email: drbaldwa@yahoo.com

Reference

1. Kaushik JS, Narang M, Agawal N. Informed consent in pediatric practice. Indian Pediatr. 2010;47:1039-46.

Reply


The term ‘process of informed consent is not well understood’ meant that it is not a well understood topic among practicing pediatricians.

Informed consent is an extremely huge topic to review. The existing literature is enormous and the review was intended to improve the existing process of informed consent in pediatric practice in India rather than providing a legal viewpoint. We acknowledge the concern of the reader that the rich resource of court cases delivered in Indian courts have been ignored. There are innumerable court cases in India pertaining to failure of obtaining consent. It was not practical to incorporate all legal perspectives in the review owing to word limit of the journal. For the same reason, the review did not cover topics pertaining to pediatric emergency care or confidentiality of information shared with the parents/guardian.

General consent for examination and basic procedure cannot be equated to implied consent, especially in situations where a female child is being examined or when their private parts are being examined or when potentially toxic medication is being prescribed. It is often essential to explain to the parents the nature of procedures being carried out on their children, purpose of doing those investigations, and the common associated hazards with those procedures or medicines.

Jaya Shankar Kaushik and Manish Narang

Email: jayashankarkaushik@gmail.com
 

 

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