Roger Hicks: Informed consent and NID
June 14, 2017
Informed consent is the process in medicine for getting permission before doing a treatment or procedure. It's a discussion that a clinician has with a patient before starting a treatment or performing surgery. It's transparency in medicine.
Informed consent includes several essential elements. The conversation includes explaining the procedure or recommended treatment plan, discussing relevant information, such as the need for the proposed treatment and the purpose of it, and a discussion of the risks, benefits, and alternatives. For it to be valid, the patient must understand what is said, and the consent must be voluntary.
If, after going through this process, the patient says yes, then informed consent has been granted. And there's another possible outcome — informed refusal. In either case, the person is fully informed.
It didn't always used to be like this. Back in the old days, the doctor might say, especially if the patient was a woman:
By refusing to livestream their meetings and make their decisions transparent, it seem like the NID board doesn’t want us
— the people who elected them
— to know what they’re doing.
"I know just what to do, dear. Don't you worry your pretty little head about the details. You just leave it all up to me and everything will be just fine. I know what's best for you."
We don't do that anymore in health care. But it seems the NID board is living back in the old days. By refusing to livestream their meetings and make their decisions transparent, it seem like the NID board doesn't want us — the people who elected them — to know what they're doing. It feels paternalistic and condescending, like one of those old-time doctors.
NID prescribed Centennial Dam for us, but there is no informed consent.
First, and most important, we don't know if it's even needed. We don't how it will be paid for, nor what those financing the project will want in return. And we haven't been told about the possible side effects. The risks are many, and include possible waste of taxpayers' money, destruction of Native American sites, condemnation of private land through eminent domain, lower real estate value for homeowners in the area, and the loss of a free-flowing river with its riparian habitat and recreational opportunities.
Before spending any more of our money on this project, It's time for NID to take a cue from the medical community.
NID should adopt best practices, and get informed consent — or informed refusal — for Centennial Dam.
A good first step would be to livestream its meetings, as is done by Grass Valley, Nevada City, Truckee, Nevada County, and many other governmental bodies.
Roger Hicks, MD, is the medical director at Yubadocs Urgent Care in Grass Valley.
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