A chronic pain patient should provide informed consent prior to starting a management program. The management of chronic pain is not without risks and the patient needs to be made of aware of these.
Components of informed consent:
(1) A complete description of the treatment to be delivered.
(2) The material risks and hazards of the treatment that a "reasonable person" would want to know.
(3) The expected benefits of treatment.
(4) The consequences of not undergoing the treatment.
(5) Alternatives to undergoing the treatment.
(6) The need to comply with the drug agreement and the consequences of noncompliance.
(7) The need to disclose all medications, recreational drugs and herbal remedies being used.
General risks include:
(1) adverse effects of any medications, including cognitive impairment
(2) the risk of dependence and misuse with opioid therapy
(3) potential impacts on family and friends
(4) positive occupational drug screening tests
Operational features:
(1) The consent should be in writing and signed by the patient or other person giving consent.
(2) The consent should be obtained by the physician.
(3) The patient should have sufficient time to reach a decision.
(4) The patient should have an opportunity to ask questions.
(5) The discussion may be done in the presence of a spouse or family member.
(6) The signatures should be witnessed by someone who is competent and capable to serve as a witness.
(7) The consent must be preserved in the medical record.
