No one taught me how to perform an informed consent. I was shown how to find the form online, and told by my senior to go consent MY patient for the lumbar puncture.
It was my second day of residency.
As I clutched the paper, I reviewed what I remembered about the lumbar puncture video I had watched the hour before. The how, why, what, where, who, when of the procedure. I was panicking. I looked down at the wrinkled paperwork, and reviewed what the paper stated to ensure that I did not miss anything important. Toward the end, my eyes stopped at the last risk. Death.
Wait, and death?
As I watched the Michael Skolnik movie, I felt guilt. I excluded the …and death in my very first informed consent. And while the procedure was more routine than brain surgery, and in retrospect went off without a single complication, the omission had never felt more wrong.
I know all consent forms include the …and death. I think until the movie I have not ever wondered why. It always felt more for the legality of the situation, and while that may continue to be true, I think that it also serves as a reminder. I have since developed my own standard for the common procedures I do in the hospital. It includes a statement to the effect of ‘ being in the hospital has risk and while the following procedure is very common there are many real risks including…
…even death.