Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Resistance to Recovery: Education

InformedInformed Consent and Anxiety

Informed consent is often structured around insuring that the patient has been duly informed of the risk-benefit ratio of clinical procedures. Informed consent does not always seek to determine the depth to which the patient understands the necessity of a procedure or the process of treatment. Perhaps more important is that the anxiety associated with physical disorders that increases when the patient feels they are stripped of control, and often their own identity.

Regardless of the amount of time or materials provided the patient to reach the level of being informed, the capacity to internalize the data is then compromised.

The first impact of anxiety upon cognitive functioning is to disrupt attention and its more complex associated skill, concentration. Regardless of the extent to which the patient is (informed)“educated,” the question remains, how much information are they capable of retaining? In the absence of the retained data, to what extent is the patient threatened, confused or alarmed by their own lack of education?

Among the means by which these issues can be addressed by the doctor are the following patient queries:

a. Has anyone spent sufficient time with you explaining both your condition and the treatment recommended?

b. Do you have lingering confusion as to what has been found and what treatment is indicated?

c. Are you able to understand the terms used by those treating you, and are you able to ask questions regarding those terms when you need more clarification?

d. Do you feel that the educational material is appropriate for you, or is there too little data to answer your questions, or too much data that confuses you?

Clarifying these issues is not only critical to the patient’s presurgical understanding. It is a necessary step of self-protection for the clinician who might otherwise be blamed for unanticipated negative outcomes.

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