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PA Supreme Court Narrows Informed Consent Requirement

Wednesday, July 5, 2017   (1 Comments)
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A recent ruling from the Pennsylvania Supreme Court has the potential to significantly impact patient care. 

On June 20, the Court ruled that, for five types of procedures, a patient’s informed consent must be obtained personally by the physician performing them. The physician cannot delegate this obligation to others, including nurse practitioners.  

All nurse practitioners involved with any of the procedures below are advised to discuss possible changes with their legal and staffing departments for guidance. 

The Pennsylvania Coalition of Nurse Practitioners will work to keep you informed as we analyze the ruling in greater detail to determine how this could impact nurse practitioner practice. We are assessing what, if any, actions are necessary including possible legal and legislative remedies. 

Additionally, PCNP is communicating with other stakeholders including the Hospital and Healthsystem Association of Pennsylvania and the Pennsylvania Medical Society to determine next steps.


The Medical Care Availability and Reduction of Error (MCARE) Act of 2002 states:

(a) Duty of physicians. Except in emergencies, a physician owes a duty to a patient to obtain
the informed consent of the patient or the patient's authorized representative prior to
conducting the following procedures:

1. Performing surgery, including the related administration of anesthesia 
2. Administering radiation or chemotherapy 
3. Administering a blood transfusion 
4. Inserting a surgical device or appliance 
5. Administering an experimental medication, using an experimental device or using an approved medication or device in an experimental manner

The Court’s 4-to-3 ruling invalidates previous court findings and regulations.  The Court wrote:

“Informed consent requires direct communication between physician and patient, and contemplates a back-and-forth, face-to-face exchange, which might include questions that the patient feels the physician must answer personally before the patient feels informed and becomes willing to consent. The duty to obtain the patient's informed consent belongs solely to the physician.”

The Hospital and Healthsystem Association of Pennsylvania statement about the ruling is here.

The Pennsylvania Medical Society statement about the ruling is here. (Note: PAMED filed an amicus brief urging the Court to continue to allow informed consent to be delegated.) 



Stephanie Alexander says...
Posted Wednesday, June 13, 2018
This is an arduous capricious decision based on one incident. This places undue burden on the health care team particularly in off hours where urgent and emergent treatments are needed.


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