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Medical/Veterinary Consent Forms

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whiteraven

MyPTSD Pro
Ok, apparently this is a little weird, but I need to start somewhere. I wrote something in Dec of 2020 about consent, but it veered off into something that was only marginally relevant to what I actually wanted to talk about (my fault--I wasn't clear because I didn't realize where all this was coming from).

Anyway, thought I'd start a new thread and see where it goes.

I have more anxiety than depression these days, although the depression is foundational. One of the areas that kicks my anxiety off the charts is being asked to sign consent forms - like at the doctor, the hospital, and for my cats at the vet.

These days, many if not most of the consent forms are signed electronically. I went to the sleep center a couple of days ago and had to sign four forms. Except I couldn't read them beforehand. I couldn't even see what I was signing. They gave me copies (without a signature) after when I asked, but I could have been signing ANYTHING.

Every hospital and doctor I've gone to does this. The vet does this. And if you read the forms, they are expecting you to agree/consent to everything, even stuff that isn't being done (like surgery, anesthesia). You are consenting to being photographed and videotaped. I tried once to write on the electronic pad that I gave informed consent only, and I couldn't.

This causes me an enormous amount of anxiety, not just for me but generally. The medical establishment demands us to be submissive, to do as they say, to not ask questions--to comply. And they often hurt more than they help. I can't deal with it.
 
I think you'd be totally within your rights to refuse to sign anything they won't let you read. There's a pretty good chance the people you're dealing with haven't given this issue any thought at all, but the whole point of a form is for you to know (and be able to prove) what you're agreeing to.

A few years ago, I got hurt at work and was being treated by an orthopedic practice. At one point, I was asked to sign a form that basically gave my insurance company permission to access any and all of my medical records, forever, for any reason they wanted to. I read stuff before I sign it too. Refused to sign it. The ladies in the office kind of freaked out. Told me that I couldn't be treated if I didn't sign. I told them it was probably the most one sided document I'd ever seen and no way was I signing it. They called the manager. I told him the same thing. He said, "Then don't sign it." There wasn't any problem at all. I got seen, insurance paid their part of the bill. Life went on. Now, I have a suspicion that if the insurance company contacted that practice about something that had nothing to do with the injury in question, those same ladies probably would have given it to them, (And it would have been with the intent of using it against me because that's how insurance companies work.) That might have been a problem, but I figure if anything tended up in court the fact that I didn't give that blanket permission would have been helpful.

I've been asked to sign more things electronically lately. I keep wondering, if there's ever a question, how to they prove who did the signing? I mean one electronic "signature" looks pretty much like any other, doesn't it? (Maybe someone smarter than me can provide the answer to that.) I don't know that I've ever had to sign any of these forms at my vet's office..... Anyway, I don't think you'd out of line asking to read it and know what you're signing. I think that's the point. Be prepared for a little eye rolling and impatience from the people you're dealing with. I think a lot of people, like you said, don't think about this stuff at all. Thinking about it is probably related to hyper-vigilance, but that doesn't mean it's a bad idea.
 
I think you'd be totally within your rights to refuse to sign anything they won't let you read.
Oh, yeah. Totally within my rights.
Told me that I couldn't be treated if I didn't sign.
This is what I was told at the hospital. They wouldn't provide the form, not before and when I asked about after, they said no. They had no way of printing it, they lied.
They called the manager. I told him the same thing. He said, "Then don't sign it." There wasn't any problem at all. I got seen, insurance paid their part of the bill. Life went on.
Glad this worked for you! I've tried the not-signing and have been refused treatment.
I've been asked to sign more things electronically lately. I keep wondering, if there's ever a question, how to they prove who did the signing? I mean one electronic "signature" looks pretty much like any other, doesn't it? (Maybe someone smarter than me can provide the answer to that.) I don't know that I've ever had to sign any of these forms at my vet's office..... Anyway, I don't think you'd out of line asking to read it and know what you're signing. I think that's the point. Be prepared for a little eye rolling and impatience from the people you're dealing with. I think a lot of people, like you said, don't think about this stuff at all.
Well, and how do we know we are signing the form they show us after? They NEVER provide the one with the signature--just a sample from the drawer.

It's just weird. Folks go on and on about consent in relationships, but we are basically giving away much of our privacy and informed consent when we sign medical documents.
 
I work at veterinary clinic. We have people sign in electronically but there is an option to paper sign. And while the vast majority of people don't read, don't think about what they are signing, I have had clients who did and one client who would not agree to everything that she was signing. We did treat her pet. We did have to review what she would and wouldn't sign so it took some sign and make sure we were ok with it. And we did treat her pet. To be honest, I can see some of my younger/less experienced or burned out coworkers saying we couldn't treat the pet or they had to sign electronically, But they would be wrong and the majority of us would work with the client. I think part of the problem is we've become so used to rules and process and they make it so hard for employees to step out of that box.

I will add there was one pet we refused to treat, because the owner wouldn't sign the anesthesia form. Which is only paper for us. Basically he wouldn't agree that we could do pre-anesthesia blood work or could try to save his pet's life if something went wrong. And while that's his right to say no, I support our choice not to treat that pet. It was a routine dental and to us, we would put the pet at too much risk to do it without those things.

I've been asked to sign more things electronically lately. I keep wondering, if there's ever a question, how to they prove who did the signing? I mean one electronic "signature" looks pretty much like any other, doesn't it? (Maybe someone smarter than me can provide the answer to that.)

In our system there's a documents file for each client. And we can print out the what the client signed with the signature that happened on the pinpad.

If none of this is helpful, just ignore.
 
The ladies in the office kind of freaked out. Told me that I couldn't be treated if I didn't sign.
If there's ever a problem with not signing a document, this is by far the most common one that crops up. Staff not knowing how to handle the situation.

Remember that it's not your fault that you don't want to sign, it's simply a choice you're making. It doesn't need to be a combative conversation - just "I'm not comfortable with...", or "can you explain...".
I don't think you'd out of line asking to read it and know what you're signing.
Absolutely agree.

And most often? Simply drawing a line through any terms you don't agree to, and initial next to it. Strike through can be an option on electronic documents, and you may need to upgrade your pdf reader for a lot of those.

Increasingly I'm finding that large organisations (such as hospitals) have their own secure system that you have to sign into to sign the document, and altering documents in those is often not available.

So call. If you have a question or concern? Call. This document wasn't created for you personally,

Reading consent forms as a regular thing will quickly help you become familiar with the nature of different terms and conditions, even though the wording varies from one document to the next. So when you come across a God clause, or a photograph clause, etc, you'll get quicker at knowing which terms you can scan quickly, and which ones you want to read thoroughly.

I've struck through photograph consent clauses in a lot of consent forms. Meh! I've never had it come up as an issue, because they weren't actually planning to take photos of me. But I felt more comfortable not authorising, so I cross it out. Contacting Next of Kin clauses are another one that I personally pay a lot of attention to, but they can't always be struck out completely.

It's a surprisingly complex area of law here in Australia. Consent forms routinely contain clauses that are entirely unforceable, and do nothing more than sound intimidating. So even if you miss something, all is not lost. Reading a consent form is helping you protect yourself, but don't feel like you lose all your rights if you forget to cross something out or take issue with something. If at any point during medical treatment or veterinary care you want something to stop? You say so, irrespective of whatever consent form you've signed.

I'd personally say that reading consent forms is a prudent, sensible habit to be in. It probably becomes hypervigilence/ptsd "stuff" if consent forms start to routinely disrupt your ability to access services that you really do need, or if it causes you distress that you're struggling to manage - in which case I'd take it to therapy for sure. Because issues around control are very often a big issue that trauma survivors need to work through, and having help/support with that process can pay dividends.
 
I will add there was one pet we refused to treat, because the owner wouldn't sign the anesthesia form. Which is only paper for us. Basically he wouldn't agree that we could do pre-anesthesia blood work or could try to save his pet's life if something went wrong. And while that's his right to say no, I support our choice not to treat that pet. It was a routine dental and to us, we would put the pet at too much risk to do it without those things.
Thanks for your response, @Muttly. Do you routinely--regardless of what is being done (for example, a general office visit)--require that clients consent to anesthesia?
Strike through can be an option on electronic documents, and you may need to upgrade your pdf reader for a lot of those.
Yeah, problem is, in the majority of these, there is not an option to look at the forms in advance.
Increasingly I'm finding that large organisations (such as hospitals) have their own secure system that you have to sign into to sign the document, and altering documents in those is often not available.
Yep.
I've struck through photograph consent clauses in a lot of consent forms.
I did in one, and discovered photos were taken anyway.
It probably becomes hypervigilence/ptsd "stuff" if consent forms start to routinely disrupt your ability to access services that you really do need, or if it causes you distress that you're struggling to manage
Maybe. It is troublesome for me, but I see it as a much larger issue. This is something I think everyone should be--at the minimum--aware and concerned about. I still get care (well, inasmuch as I can get past the general trust issues), but I worked in medicine for a very long time (as have several family members), and I know that among many, many "professionals," consent and privacy mean squat. Charts are read by people who shouldn't be reading them, information is shared with people who don't need/aren't entitled to it, procedures are done under anesthesia without the express, informed consent of the patient, employees violate HIPAA and it's shoved under the rug, and meds are given without any information to the patient.

I have multiple examples of each and more. I was in a doctor's office once, and someone's insurance was being verified by the receptionist; everyone in the office heard her full name, address, diagnosis, and social security number.

I think there is a fine line between hypervigilance and anger/anxiety over corrupt practices within the medical establishment.
in which case I'd take it to therapy for sure.
Oh, we've discussed, and he agrees with me.

If at any point during medical treatment or veterinary care
Oh, agree. Except some of veterinary care is done outside the view of the client. But generally, yes...def agree.

I guess my biggest issue with the forms I was requested to recently sign (for a general office visit for my cat) was that they were incomplete--they include everything (anesthesia, etc) for any sort of visit. No worries. I didn't sign and won't until I get to the office.
 
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