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Informed consent is not subject to any formality, however it is recommended that part of the history . There are cases where it is mandatory written and others that can be ignored. In the field of public hospitals is governed by resolution 435

The doctor-patient relationship is assumed governed by principles of good faith, dignity and mutual respect among people, where the doctor with knowledge, experience and Bonomia have the means to mitigate the effects of the disease and the patient with pain and anguish flow freely, voluntarily and consciously to the allocation that gives autonomy principle and the expectation of recovering their health, consent or not to be subjected to treatment proposed.

From the medicolegal aspect is a contractual relationship where both parties are committed to a common goal: to restore patient health. With regard to knowledge of both, is asymmetrical because the doctor is holding them because of their professionalism. Thus, informed consent, and symmetrical relationship becomes legitimate medical act.

This aspect has been said that "the physician's responsibility in the absence of a contract is purely extra-contractual or quasi-delict, why not apply the rules enshrined in illegal acts (Civ. C. Apel and Com. San Martin, room and 28/09/1979. SJA and other C / TLM and other LL, 1980-A-413) (1).

This informed consent is the agreement freely, voluntarily and written by a capable patient to medical treatment. Arises of discernment of what is explained by the doctor about disease characteristics, treatment type, duration, type of incisions, anesthesia, alternative treatment options, complications and sequels Frequently (2).

Consent is recognized from the beginning of the century when Cardozo said: "Everyone founded as an adult and reasoning, has a right to determine what to do with her own body" (3 ), (cit. Schloenndorf v / Society of New Hospital, 211, NY. 125, 105, IN. 92, 1914).

can be expressed when expressed verbally or, better yet written or implied as acceptance of medical treatment in the emergency (4). Should be determined by the patient lucid and capable, to be ineffective, therefore, the consent given by an incompetent (see Table I and II) (2).

written informed consent is mandatory in cases of minor surgical procedures, amputations, organ transplants, particularly in those practices that endanger the life or vital functions. In these cases provided by law 17,132, Article 19, paragraph 3: "In the twinkling operations will be sought the patient's written consent, except when unconsciousness or alienation or severity of the case admitted no delay." In the practice is that it should be pampered all surgical practices, because in fact none are without complications.

Informed consent is not subject to any formality (8), it should nevertheless be part of history, written by the doctor and signed by the patient's guardian or more responsible, after having met with a cautious advance particular explanations of his case, stating clearly and simply the diagnosis, treatment, alternatives, risks, major complications and sequelae. The attending physician disclosed patient information directly, single detainee, with the breadth and depth necessary and sufficient, according to the characteristics of each patient, extent of disease or pathological condition and extent of treatment to be submitted.

On the contrary, a patient can consent without having been given his chance in the explanations for the treating physician, or without having understood the mere formality of the signature, invalid , would in our view, both ethically and legally consent. It also legitimizes the consent medical act to carry out treatment but does not exempt per se liability in the event that a wrong action, negligently or recklessly causes damage to the patient's health.

DEFENCES OF INFORMED CONSENT

- Emergency

Where the characteristics of the patient's chart because of their gravity and urgent need appropriate treatment instituted, do it to be implemented immediately to preserve the health of the patient, is exempt from the consent explicit. For such conduct is lawful, the picture should become an imminent threat to the health of the patient and the physician, be oblivious to the cause of that table. Respect Article 34 of the Penal Code provides: "No punishment would result in whom to avoid a greater evil that has been strange" (paragraph 3) or who act in pursuance of a duty or in the legitimate exercise of a right , authority or duty "(paragraph 4).

Dr.RoqueO.Nigro

Dr. Oscar Lossetti

Dr. Carmen Maria Ferraiolo

MEDICAL-LEGAL GUIDANCE AND PROCEDURE

World Journal Supplement Hospital, Association publication Municipal Medical Buenos Aires City - Year 4 No. 17 - November 2000

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