Enforcing patient preferences. Linking payment for medical care to informed consent
M. B. Kapp
Department of Medicine in Society, Wright State University School of Medicine, Dayton, Ohio 45401-0927.
The legal and ethical doctrine of informed consent is well accepted in
modern medicine. Nonetheless, medical interventions sometimes take place in
the absence of informed consent, particularly in the case of
life-sustaining medical procedures. These procedures ordinarily are
reimbursed by third-party payers. This article proposes as a strategy to
ensure greater attention to patient preferences in medical decision making
that financial reimbursement for each medical service be linked to a
requirement of valid patient (or surrogate) consent to the service
involved. Utilization review bodies could monitor informed consent in the
same way that other aspects of necessity, appropriateness, and quality are
now monitored.
