Does your Provider use "Blanket" or "General Consent" Agreements?

Does your Provider use "Blanket" or "General Consent" Agreements?

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Let Steve Allen, CEO of Nationwide Children’s Hospital, and the Ohio House of Representatives Health Committee know that you disagree with “implied”, “general”, and “blanket consent” policies.
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NCH General Consent

***OAMF is forwarding the following letter to you on behalf of one of our valued members.***

CC: Ohio House of Representatives Health Committee

Dear Steve Allen, CEO of Nationwide Children’s Hospital:

Nationwide Children’s Hospital makes use of a “blanket” consent form for medical treatment called the General Consent form. Hospital policy states that "Parents or guardians do not need to sign an additional consent for vaccinations" because "Vaccinations are medications and consent is provided with the signing of the General Consent form." As a concerned citizen and consumer of health care services, I take major issue with the use of this policy and the potential administration of vaccines that a parent may not know about or want for their child.

First, general consent forms, also known as blanket consent forms, like this do not align with the ethical principle of informed consent. Patients or their parents are, by Ohio law (ORC 2317.54) and international declaration, to be given information about the risks and benefits or even the full nature of the procedures and what is expected to be accomplished in a manner satisfactory to the patient (or parent).

Second, a Vaccine Information Statement (VIS) is required to be provided BEFORE the vaccine is given. Blanket consents, particularly ones that state consent for vaccination, is at risk of violating this law. According to the CDC: “All vaccine providers, public or private, are required by the National Vaccine Childhood Injury Act (NCVIA – 42 U.S.C. § 300aa-26 to give the appropriate VIS to the patient (or parent or legal representative) prior to every dose of specific vaccines.” I am especially concerned about parents who may not understand, due to language or other barriers, their rights to decline any and all vaccines and to have full informed consent.

Finally, as a hospital under the direction of Health and Human Services, you must be aware of the Conscience and Religious Freedom Division tasked with enforcing “federal laws that protect conscience and the free exercise of religion and prohibit coercion and discrimination in health and human services.” Families visiting your facilities should be provided with information about vaccine ingredients/media such as aborted fetal tissue, animal-based tissues, and various adjuvants and preservatives that may conflict with their conscience and religious beliefs or practices.

Ohio has a rich tradition of supporting civil liberties and religious / conscience freedoms. Nationwide Children’s Hospital, by recognizing the shortcomings in their General Consent policy and modifying or eliminating vaccines from it, will actively recognize parental rights consistent with sections 1.07 and 1.21 of the Ohio Constitution, prevent discrimination based on language / culture / conscience / religion, and support parental informed consent for a child's vaccination decisions.

On behalf of all Ohio citizens, I thank you for your understanding and action on this important issue.

Sincerely,

**your signature**

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Some hospitals and medical facilities are using “blanket” consent agreements that include vaccination. This means that someone can give you or your child a vaccine deemed necessary without obtaining further consent. Moreover, many of these are electronic and some facilities are saying these are unalterable. This practice goes against your informed consent and medical freedom rights to decline any, part of, or all medical products and procedures recommended. Beware of blanket consents, standing orders, and even medical practitioners who give shots to patients who aren’t fully awake and cognizant!

While in the Care of Health Care Providers

DENIAL, HARASSMENT OF, or FAILURE TO INFORM parents of their RIGHT to to decline vaccinations, standing vaccination orders, and policies that encourage health care professionals to harass parents of vaccinated children is not only unethical, it’s unconstitutional. “The Supreme Court of the United States has traditionally and continuously upheld the principle that parents have the fundamental right to direct the education and upbringing of their children. A review of cases taking up the issue shows that the Supreme Court has unwaveringly given parental rights the highest respect and protection possible.” (HSLDA)

Yet Ohio Advocates for Medical Freedom continue to hear story after story from parents of children who received medical treatment, in the form of vaccinations, without their knowledge or consent; including vaccination of students while at school, while a parent is absent from the room at a pediatrician’s office, when parents are unreachable during an emergency visit to the hospital, when babies are taken from their mother’s after birth for examination, and so on.

What is Informed Consent?

“Although the concept of consent is rooted in ancient legal and philosophical precepts, the modern legal precedent for ‘simple’ consent was written in 1914, establishing a patient’s ‘right to determine what shall be done with his body.’ The further obligation for physicians to disclose details about treatment in a process of informed consent did not emerge until the 1950s, when courts first required physicians to disclose information customarily disclosed by experienced clinicians (e.g., the reasonable physician standard). It was not until 1975 that American courts articulated the reasonable person standard, which required that physicians disclose the information that a ‘reasonable person’ would want to know in a similar situation.” (NCBI)

Do Standing Orders (aka: Order Sets) respect Informed Consent?

“Standing orders authorize nurses, pharmacists, and other appropriately trained healthcare personnel, where allowed by state law, to assess a patient’s immunization status and administer vaccinations according to a protocol approved by an institution, physician, or other authorized practitioner. Standing orders work by enabling assessment and vaccination of the patient without the need for clinician examination or direct order from the attending provider at the time of the interaction. Standing orders can be established for the administration of one or more specific vaccines to a broad or narrow set of patients in healthcare settings such as clinics, hospitals, pharmacies, and long-term care facilities.” (immunize.org) In recent years, health care providers have added “routine vaccination” to their standing orders, and there’s even new lobbying groups advocating for them.

The issue with vaccinations being administered as a part of standing orders is that it bypasses informed consent from parents. When a child is under the care of a health care worker who has standing vaccination orders, they are not required to obtain permission from a parent prior to administering the vaccine, any more than they’re required to obtain permission to take a child’s temperature or blood pressure.

Does Implied, General, or Blanket Consent respect Informed Consent?

Implied consent is an assumption of permission to do something that is inferred from an individual’s actions rather than explicitly provided. Implied consent contrasts with express consent, which is explicit verbal or written permission.

General consent, blanket consent, or “consent and acknowledgement” is a grey area between implied and express consent. The Consent and Acknowledgement form is a general consent signed by the patient, or his or her representative, in the presence of a hospital staff member at the time of, or shortly after, admission to the hospital. It provides a record of consent to routine hospital services, diagnostic procedures, and medical treatment.

The problem with implied, general, and blanket consent, as well as the “consent and acknowledgement” forms, is that they do not ensure patients receive through informed consent prior to a procedure, particularly when a patient is incapacitated. In the case of child patients, they permit the provider to perform procedures on child patients without parents or guardians even being present.

How to ensure your wishes are honored:

Always have an advocate present while receiving medical treatment to ensure that your wishes are honored. If you’re a parent, simply do not leave your child’s sight without an advocate present to ensure your wishes are honored in your absence.

If admitted to a provider that issues wristbands during your visit, write any important directives in permanent market on the wrist band. Clinicians verify your identity with your wrist band every time they perform procedure. They cannot claim they didn’t know your wishes if they were forced to look at it prior to every procedure.

When signing registration paperwork, which often includes consent documentation, make sure to read the paperwork and cross out anything you do not agree to. Also make sure to write any important directives on the consent paperwork so there’s no denying that you expressed your wishes. If the paperwork is electronic, squeeze a couple important notes in on the signature pad.