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Linking Payment for Medical Care to Informed Consent

Marshall B. Kapp, JD, MPH

JAMA. 1989;261(13):1935-1938.

Abstract
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.

(JAMA. 1989;261:1935-1938)

Author Affiliations
From the Department of Medicine in Society, Wright State University School of Medicine, Dayton, Ohio. The views expressed in this article are solely those of the author.

Footnotes
Reprint requests to Department of Medicine in Society, Wright State University School of Medicine, Box 927, Dayton, OH 45401-0927 (Mr Kapp).

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