By C. Nunley, GRCC, KY
Do you know what “consent” means? Maybe you think that you might, or perhaps you know what the dictionary defines it as, but did you know that legally, as far as the healthcare system goes, there are two basic types of consent?
The first type of consent is known as “implied consent.” This type of consent is typically based on actions rather than words. One example of implied consent is in emergencies. If you are found unconscious and not breathing, the law basically says that a reasonable person would assume you want them to save your life, so consent is implied without you having to say anything.
The second and most overlooked, but perhaps the most important, is “informed consent.” It is the type of consent that I would like to discuss in this article. I could bore you with a textbook definition using a lot of big words that you may or may not care to read, but let’s just use plain English. Essentially, this means that when you go see a healthcare professional, they are supposed to sit down and explain what your diagnosis is, what happens if you don’t get treatment, what treatments are available, and what bad things can happen to you if you decide to take the treatment. In many states, providers are required by law to get informed consent. If it isn’t illegal to neglect this duty, it’s at least a violation of the ethical codes that doctors and nurses are held to.
The best personal example that I can give is what happened in my own case. After my initial sentencing, I sought help from the psychologist in the medical department. She referred me to the psychiatrist, who diagnosed me with clinical depression, complicated by long-term insomnia. That doctor proceeded to prescribe a series of medications that were not what I needed. These included a “cocktail” of Zoloft (sertraline), Risperdal (risperidone), Haldol (haloperidol), Remeron (mirtazapine), and Desyrel (trazodone). Every time that I had an appointment and could think to explain that the meds weren’t working as I thought they should, the telehealth doctor would simply increase the dosages.
Not one time did the doctor explain anything about the medication regimen or any possible adverse effects. So, for ten years, I was given this “cocktail” the whole time without knowing that the adverse effects would be permanent. As a result, I now have a permanent neuromuscular condition called tardive dyskinesia. While this condition has been known about for decades, pharmaceutical companies have only recently released treatments for it in the past few years.
The vendors/contractors charged with providing us healthcare seem to think that they can just prescribe whatever because in many cases, when one of us presents with signs and symptoms of long-term adverse effects, it’s too late for us to seek any sort of legal remedy in most jurisdictions.
The only treatment for tardive dyskinesia is a daily dose of even more medication, so the cycle continues. In my case, after five years of discontinuing the medications, the condition has eased up. But it will never go away, and I will continue to have issues with it for the rest of my life. Had the doctor taken 15 minutes to explain and discuss the well-documented adverse effects of the medications with me, I would have looked for another way. EVERYONE NEEDS TO KNOW THIS!!
The problem with healthcare today in here, as well as the outside world, is that entirely too many doctors are too fast on the draw with that prescription pad. Nobody takes the time to do a patient history interview anymore, so they don’t know or seem to care that maybe their patient has been self-medicating with a substance that might be incompatible with whatever pill they want to cram down our throats.
Even as inmates, we do retain some basic constitutional rights (albeit a scaled- down version). However, as HUMAN BEINGS, we do have the unalienable right to consent, in any form, and we certainly have the right to know what we are putting into our bodies and what it can do for us or to us.
How many of us would not be in here had Purdue Pharmaceuticals not lied to everyone about how addictive their products were?
“Turn It Up” magazine recently published an article that really deserves attention! And with it, they published a “Patient’s Bill of Rights for Incarcerated Persons.” This proposed Bill of Rights was created by the men behind the walls of Sing-Sing and Green Haven prisons in New York. It is well thought out and should be implemented across the corrections systems in all 50 states immediately.
I present it here, in this forum, for your review.
- Ensure the use of gloves by healthcare providers, including when dispensing medication.
- Prompt responses to all medical emergencies.
- Staff to maintain confidentiality, limiting access to medical files and requiringofficers to stand away from exam rooms.
- Clinicians to keep instruments sterile and inside packaging until in front ofpatient.
- Clinicians to notify patients of the medications being prescribed. [Note fromwriter: I take this to mean informed consent and what the medications will do.]
- Presence of emergency alarms in porter cells for quick responses to medicalemergencies.
- AEDs [automated external defibrillators] accessible in program areas anddormitory areas.I would like to add the following: Refer to us as “patients” and not “offenders” because no matter what the crime that brought us here was, no matter how seemingly insignificant or heinous, we are all human, and we all deserve a chance at redemption.
Permission to reprint or cite this article is given by the author with the provision that credit is given to the publisher and the author.