In the old days it was believed: once a person asked for medical help, he agreed to everything in advance. The doctor, of course, outlined the situation and could even give a hint about the consequences and side effects, but no more.
To find out the details, one had to show wonders of perseverance and diplomacy. In 1993, everything changed: the law of the Russian Federation “Fundamentals of the Legislation of the Russian Federation on the Protection of Citizens’ Health” secured for the first time the Russians the right both to informed voluntary consent about any medical intervention and to refuse it.
For a child under the age of 15, he must be given the legal representatives of a minor (most often these are parents).
From January 1, 2013 this document became mandatory.
The future mother can feel her responsibility for the unborn baby, having barely crossed the threshold of the maternity hospital. In some clinics, realizing that the labor had begun, the duty doctor, right in the emergency room, spreads a decent pile of papers in front of a dumbfounded woman. Among them – and the informed voluntary consent to medical manipulations regarding the future of the crumbs or rejection of them.
In other maternity hospitals, such documents are suggested to be signed immediately after the birth of the child. Of these, the most important are consent to vaccination of the newborn from hepatitis B and tuberculosis or rejection of it.
You must admit that in both cases, it is far from the most convenient time to think and make an important decision. Under such circumstances, a doctor has no time to educate and talk about the benefits of vaccination and possible side effects, and a woman can hardly ask clarifying questions and go into details. That is why children’s doctors strongly recommend expectant mothers, choosing a maternity hospital, be sure to meet with neonatologists and, as they say, learn all the details first hand.
At an advisory consultation, the doctor will explain in detail why vaccination is needed, what consequences a refusal can have, answer all questions and demonstrate a document that needs to be signed.
The form can also be found online and printed. And there will be a desire – to fill it in a calm atmosphere, after consulting with both doctors and relatives or friends.
Do not worry: if the crumbs have contraindications for vaccination, a record of the medical issue will appear in his card and they will not be vaccinated.
When registering a child for an appointment with a doctor, just in case, specify whether the presence of one of the parents is mandatory. After all, according to the law, grandmothers, grandfathers or babysitters are not allowed to sign consent to injections, anesthesia and other manipulations.
Keep in mind that under the new rules, voluntary informed consent or refusal of medical intervention will have to be signed by one of the parents at each visit with a crumb to the clinic, a call to the doctor’s house or an “First Aid”.
On the one hand, by offering to sign this document, the doctor spreads a straw for himself: he cannot declare that the injection was made to the child without their knowledge, and the parents will not be able to make a complaint. On the other hand, the paper protects the rights of those who applied for medical care.
By law, the doctor must describe in detail all the procedures that await the crumbs, as well as talk about the results of treatment and possible side effects. He is obliged to warn about the consequences of failure.
And it is necessary to act according to the principle: in the morning money – in the evening chairs, that is, you first learn the details and get answers to all your questions, and only after that you sign an agreement or refusal.
For example, if the doctor did not tell why the crumbs need to remove the adenoids, do not settle for the operation until you are sure that the baby really needs it. When a doctor refuses detailed explanations or is unable to clearly state everything in a language that is accessible to a layperson, it is better to turn to another specialist.
There is one more very important nuance. Signed voluntary informed consent, contrary to popular belief, does not relieve the medical worker from responsibility for the mistake.
If a child has had complications as a result of the treatment, doctors not only can make a claim, but they should. To understand whether the doctor is guilty, a special examination is appointed.
It establishes whether it was an individual reaction of the body, which is impossible to predict, or medical error.
Ideally, voluntary informed consent should be signed for each manipulation separately. But it is impossible to foresee all cases. Therefore, in kindergartens parents are given a form, which mentions both the initial examination, and the treatment of wounds, and the use of medical preparations.
You can give your consent to all types of manipulations or only some of them. Consent to vaccination or refusal from it is always made separately.
By law, parents can refuse any medical manipulation, including vaccinations. In this case, feel free to refer to Articles 32, 33 and 34 of the Fundamentals of the Legislation of the Russian Federation on the Protection of Citizens’ Health, as well as Chapter II, Article 5, paragraph 1 of the federal law On Immunoprophylaxis of Infectious Diseases.
In the heat of clarifying relations with medical workers, not to forget anything and not to lose sight of, lawyers recommend to print out the forms of refusals in advance and enter their name, patronymic name and surname in them, put a date and a signature. The application is written in the name of the head of the institution, for example, the head physician of the polyclinic, the head of the kindergarten, etc. The document is glued to the medical record (medical history) of the baby.
In this case, the doctor is obliged to tell what the consequences may have a failure.
For example, during an epidemic a non-vaccinated child can not be accepted or not allowed into kindergarten.
You can withdraw your refusal at any time. And if the medical manipulation has not yet begun, then it is allowed to reverse the course and signed voluntary medical consent.
This is also done in writing.
When signing consent or refusal, do not be lazy to carefully examine the document and ask the doctor in detail about what the baby is going to have about the diagnosis, indications and contraindications, possible complications and side effects. Be sure to warn the doctor if the toddler, for example, had an allergic reaction.
Make sure that all appointments and manipulations are recorded in the medical card crumbs. Trust is necessary, but also to check whether something is missing, it never hurts. For example, when prescribing drugs, the frequency of their intake and dosage should be indicated.
So do not hesitate to ask the doctor to show you this document.