This letter is in response to "Informed consent" (Letters, #93). Telling the patients that your survival is 50-50, that too at point blank as stated in an earlier letter by Jyoti Lohani (Letters, #91) is not informed consent. The Bumrungrad Hospital says it was explaining the potential outcome of the treatment as "informed consent", but it also requires that permission be obtained from the patient or patient party (if the patient is not in a position to give valid permission) before carrying out any treatment procedures or research. Explaining the outcome of any treatment is only the compulsory obligation to be carried out by physicians or surgeons. It is better to take permission of the patient's family before explaining the whole truth about the disease and outcome of the treatment when there is less chance of survival. Patients already suffering from a debilitating disease are vulnerable to the harsh reality, and may develop psychological problems like depression.
It is true that in many Asian countries the concept of informed consent is virtually nonexistent. But it is not true that it is a totally new concept in Asia, since it is used in Japan, Singapore, South Korea. In most Asian countries, when patients come to a doctor it is taken for granted that they have given their consent for treatment and they have to accept the consequences if any arise. Since patients are not always in a position to make the valid decision, family members need to be consulted before obtaining informed consent and starting treatment.

Dr Sudhamshu
Chiba, Japan