Informed Consent: Legal Duties to Discuss Costs of Treatment

Three years ago, I wrote a short article arguing that physicians have a duty to disclose the costs of treatment, especially when those costs are very high. Newer legal developments have made the case even stronger. One example is a new regulation from the Department of Veterans Affairs.

The regulation requires that the practitioner discloses to and discusses "appropriate information" with a patient. "Appropriate information" is defined as information that a reasonable person in the patient's situation would expect to receive in order to make an informed choice about whether or not to undergo the treatment or procedure. This is the patient-oriented material risk standard in force in about 20 states.

But the VA regulation continues. It states that "appropriate information" includes "tests that yield information that is extremely sensitive or that may have a high risk of significant consequence (e.g., physical, social, psychological, legal, or economic) that a reasonable person would want to know and consider as part of his or her consent decision.).

This is significant because the Veterans Health Administration is the largest integrated health care system in the United States, providing care at nearly 1300 health care facilities.