Re: Informed Consent for prenatal ultrasound

From: Paula S. Woletz, MPH, RDMS, RDCS (woletzps@umdnj.edu)
Fri May 14 16:28:32 1999

It's been a killer week, so please excuse this if it comes out garbled.

Frank Chervenak has been advocating obtaining informed consent for OB scans since 1989 (see Chervenak FA, McCullough LB, Chervenak JL. Prenatal informed consent for sonogram (PICS): An indication for obstetrical ultrasound. Am J Obstet Gynecol. 1989; 161:857-860), but I haven't seen it widely accepted. His argument does make sense, though. Anyone remember an article in the New York Times a few years ago titled "Ultrasound and fury: One woman's ordeal" and the letters to the editor in response? I think we may underestimate how infallible patients perceive us and the technology to be. When there's a misdiagnosis, false negative or false positive, there's a tremendous backlash.

We can ask patients to sign a piece of paper which acknowledges that we're not always 100% right. But whether we use informed consent or not, we need to develop a good rapport with our patients, communication skills, and a fair dose of humility regarding the limitations of even state-of-the-art practices.

Is it time to go home yet?

Regards, Paula

At Fri, 14 May 1999, DuBose, Terry wrote: >
>In my 23 years, I have never seen an informed consent for any sonographic
>procedure that did not involve needles or some sort of invasion. Not even
>for endovaginal... which some might consider an invasion. This is a new one
>on me... do you think it was just an idiosyncrasy of these two surveyors, or
>is this a real policy change for the JCAHO?
>
>Good luck with the accreditation... crossing my fingers for you.
>
>Peace, Terry J. DuBose, M.S., RDMS, FAIUM
>University of Arkansas for Medical Sciences
>Little Rock, AR, USA
>http://www.uams.edu/CHRP/dmshome.htm <http://www.uams.edu/CHRP/dmshome.htm>
>- http://www.io.com/~dubose/ <http://www.io.com/~dubose/>
>
> -----Original Message-----
> From: jworrall@alaska.net [SMTP:jworrall@alaska.net]
> Sent: Friday, May 14, 1999 10:02 AM
> To: Multiple recipients of list ULTRASOUND
> Subject: Informed Consent for prenatal ultrasound
>
> Our Clinic is in the midst of a JCAHO Accreditation Survey
> (yesterday and today). Last evening at the first day summation
>briefing
> both surveyors (an MD and an administrator) recommended that we
>obtain
> informed consent for every prenatal ultrasound.
>
> I do not believe we are going to get a serious demerit because we do
>not
> presently do that. I readily agreed to do it. It can do not harm,
>and
> will not be a major problem for my ultrasound practice since I do
>only
> zero to four ultrasounds per day including gyn scans.
>
> I thought I would let everyone know.
>
> PS - the survey is going well and I think we will become Accredited!
>For
> those of you who have been through this, you know what a big deal it
>is!
>
> --
> Joseph A Worrall MD RDMS
> Fairbanks, Alaska

--
Paula S. Woletz, MPH, RDMS, RDCS
University of Medicine and Dentistry of New Jersey/
St. Peter's University Hospital
New Brunswick, NJ
woletzps@umdnj.edu



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