In order to obtain informed consent, care providers are required, within reason, to provide patients with the medical information necessary to make a decision regarding the proposed treatment
It is forbidden to provide medical treatment without first providing the essential necessary information and obtaining the patient's consent to treatment
If medical treatment was performed without providing medical information as required, the patient may file a monetary suit against the relevant care provider and the medical facility
In certain cases, and with ethics committee approval, a care provider may withhold medical information and still obtain the patient's consent
In order to obtain informed consent, care providers are required, within reason, to provide patients with the medical information necessary to make a decision regarding the proposed treatment.
- If the required information has not been given to the patient, patient consent to medical treatment is not valid, and the care provider may not perform the medical treatment, except in exceptional cases where it is permitted to withhold the information.
- If medical treatment was performed without providing medical information as required, the patient may file a monetary suit against the relevant care provider and the medical facility.
Who is Eligible?
- All patients.
Information that Must be Provided to the Patient
- Care providers must disclose all information required by the patient to make a decision regarding treatment, including the following (among other things): diagnosis, prognosis (predicted development of the condition without medical treatment), proposed treatment, alternatives to the proposed treatment, chances and risks of the proposed treatment, nature of the treatment (invasive or non-invasive), treatment duration, information regarding the history of the treatment (if it's a relatively new type of treatment, etc.)
Diagnosis and Prognosis
- The care provider must provide the patient with the diagnosis and the prognosis of the medical condition.
Information Regarding Proposed Treatment
- The care provider must describe the following regarding the proposed treatment:
- Nature of the treatment process (i.e. if the treatment is invasive, the degree of invasiveness, such as taking blood, taking a skin graft, penetration into internal organs, etc.)
- Duration of time the treatment process will last
- Parts of the body involved in or affected by the treatment process
- Purpose of the treatment process (i.e. pain relief, healing, or prevention)
- Predicted utility of the treatment process (i.e. complete restoration of vision)
- Chances for success of the proposed treatment (i.e. 50% chance that the surgery will restore vision)
Inherent Risks of Proposed Treatment and Refraining from Treatment
- The care provider must inform the patient regarding the inherent risks of the proposed treatment, and the inherent risks of not receiving medical treatment, including side effects, pain, and discomfort.
- The care provider is not obligated to inform the patient regarding all inherent risks of the proposed treatment, especially rare risks. The care provider is only obligated to provide information regarding substantial or significant risks. As long as there is a high chance that a particular risk may occur, and as long as the potential result of that risk (if it were to occur) is severe, the care provider is obligated to provide this information to the patient.
If there is an 80% chance that the treatment will lead to the patient's death, this information should be disclosed to the patient.
If there is a 0.5% chance of mild temporary pain inherent in a treatment intended to save the patient's life, this is a risk about which the care provider is not obligated to inform the patient.
- For elective procedures (such as cosmetic surgery), the care provider's obligation to disclose risks is broader. In these cases, the care provider must even inform the patient regarding milder potential risks with lower chances of occurring.
If there is a 5% chance of chronic runny nose inherent in a cosmetic surgery, this is a risk about which the care provider is obligated to inform the patient.
- If the patient refuses the proposed medical treatment, the care provider is obligated to inform the patient regarding the inherent risks of not receiving treatment.
A man comes to the emergency room suffering from strong chest pain. Despite the fact that the doctors recommend he be hospitalized for monitoring and examination purposes, he refuses to be admitted and decides to go home. In this case, the doctor is obligated to inform the patient regarding the inherent risks of leaving the hospital.
Prospects and Risks of Alternative Medical Treatments
- The care provider must present the patient with possible alternative medical treatments to the proposed treatment, as well as the prospects and risks of those treatments.
- The obligation to inform the patient regarding alternative medical treatments is only relevant regarding treatments that are known and accepted in the medical world.
A woman who is in week 24 of her pregnancy comes to the hospital because she is bleeding. The bleeding does not lead to a miscarriage. The care provider is not obligated to inform the patient about the option of performing an abortion despite the fact that bleeding at this stage of pregnancy may indicate an increased risk of giving birth to a premature infant. The reason for this is because an abortion in this situation does not constitute an accepted medical alternative in the medical world.
- The care provider is also obligated to inform the patient regarding the option of not receiving medical treatment, if refraining from receiving medical treatment is an accepted option in the medical world.
A man suffering from severe back pain goes to an orthopedist. According to the medical literature, the patient may be treated in one of the following ways:
- Pain relief injections
- Conservative treatment consisting of rest and refraining from active treatment
- The obligation to inform a patient regarding alternative medical treatments is not limited to treatments included in the healthcare basket. The care provider must also inform the patient regarding treatments not included in the healthcare services basket, meaning treatments that can only be obtained if purchased privately, if they would provide proven benefits to the patient.
Gynecologists must inform pregnant women about the possibility of performing a more comprehensive scan (intended to discover potential birth defects) than that which is performed as part of the public health system, even if there is no medical indication that the scan is necessary, such as genetic background.
- The obligation to inform a patient regarding alternative medical treatments is not limited to treatments performed in Israel. In certain instances, the care provider may also be obligated to inform the patient regarding treatments which are only available abroad.
- When a proposed treatment is innovative, meaning it is not experimental but there is not a great deal of experience performing it, the care provider must inform the patient regarding this fact, as well as of the consequences (i.e. uncertainty regarding long-term consequences or effects of the treatment).
- The information described above is not complete or set. In certain circumstances, additional information must be disclosed above and beyond that which is detailed above.
- The care provider must provide all information which is essential for the patient to make a decision regarding whether or not to consent to receive a proposed treatment.
The care provider may be required to inform the patient that he/she does not have experience performing a certain procedure that requires much skill and experience.
- All essential information must be disclosed to the patient, even if doctors do not normally share the information.
Even if most doctors do not generally share with pregnant women the inherent risks of speeding up birth, the care provider is obligated to disclose this information to a pregnant woman under his/her care because it is essential information for her.
Manner of Disclosing Information
- The law does not establish any particular manner of disclosing information to patients.
- The care provider may decide to disclose information to the patient verbally, in written form, or in any other way (i.e. by means of a video recording, audio recording, computer program, etc.)
- The care provider must use clear words and not professional medical language, depending on the patient's needs and level of comprehension.
- The care provider must provide the information in a language the patient understands.
- According to Ministry of Health Director Circular No. 7/11 from 03.02.2011 regarding cultural and linguistic accommodations and accessibility in the healthcare system, information must be disclosed to patients in a language that is clear to them, even by means of an interpreter when required.
- Care providers should refrain as much as possible from using a family member of the patient as an interpreter, unless the patient has requested this of their own initiative and free will.
- A family member who is a minor should not be used as an interpreter, except in emergency situations or to disclose simple, age-appropriate information.
- For more information about translation and interpreting in the healthcare system, see: Translation and Interpreting Services for Patients in the Healthcare System.
Exemption from Disclosure of Information
- The care provider is not required to disclose information to the patient if the following two conditions are met:
- Disclosure of information is liable to severely damage the patient's physical or mental health (i.e. a patient with a heart condition is liable to have a cardiac incident if it is revealed to him that he has another severe illness, or a patient with suicidal tendencies may try to harm himself if this information were revealed to him).
- An ethics committee has permitted withholding of the information from the patient.
- In these cases, it is only permitted to withhold the information that could damage the patient's health. The care provider is still obligated to disclose information about the proposed treatment to the patient including the nature of the treatment, its purposes and inherent risks.
- It is forbidden for a care provider to provide false information to a patient.
- The exemption is only from disclosing the relevant information, and it is not an exemption from obtaining informed consent from the patient. The care giver must obtain informed consent from the patient before beginning the treatment.
- If essential medical information has not been disclosed to the patient, or if inaccurate or false information regarding the medical treatment has been provided, and the patient has provided consent to receive the treatment, this consent is not valid and it will be considered as if no informed consent to treatment has been given. In this case, it would be forbidden to perform the medical treatment.
- For a comprehensive categorized listing of healthcare organizations offering assistance and support, click here.
Laws and Regulations
- Ministry of Health Director Circular No. 7/11 from 03.02.2011 - Cultural and linguistic accommodations and accessibility in the healthcare system
- The Patient's Rights Law, Section 13
- Original information in this entry written by the Mazor Clinical Center - Providing Legal Advice Regarding Patients Rights in Israel.
- English translation and maintenance by The Shira Pransky Project.