Informed Consent Is Vital: Fill Out These Forms

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Informed Consent Form and Why It’s Important by

  • Medical Author: Richard A Wagner, MD, PhD 
  • Medical Editor: James E Keany, MD, FACEP 
  • Medical Editor: Francisco Talavera, PharmD, PhD 
  • Medical Editor: Jeter (Jay) Pritchard Taylor III, MD

 Privacy & Trust Info

What Is Informed Consent?

There are 4 components of informed consent including decision capacity, documentation of consent, disclosure, and competency. 

  • Doctors will give you information about a particular treatment or test in order for you to decide whether or not you wish to undergo a treatment or test. This process of understanding the risks and benefits of treatment is known as informed consent.

  • Informed consent is based on the moral and legal premise of patient autonomy: You as the patient have the right to make decisions about your own health and medical conditions.

  • You must give your voluntary, informed consent for treatment and for most medical tests and procedures. The legal term for failing to obtain informed consent before performing a test or procedure on a patient is called battery (a form of assault).

  • For many types of interactions (for example, a physical exam with your doctor), implied consent is assumed.

  • For more invasive tests or for those tests or treatments with significant risks or alternatives, you will be asked to give explicit (written) consent.

  • Under certain circumstances, there are exceptions to the informed consent rule. The most common exceptions are these:
    • An emergency in which medical care is needed immediately to prevent serious or irreversible harm
    • Incompetence in which someone is unable to give permission (or to refuse permission) for testing or treatment

What Are the 4 Principles of Informed Consent?

There are 4 principles of informed consent:

  • You must have the capacity (or ability) to make the decision.

  • The medical provider must disclose information on the treatment, test, or procedure in question, including the expected benefits and risks, and the likelihood (or probability) that the benefits and risks will occur.

  • You must comprehend the relevant information.

  • You must voluntarily grant consent, without coercion or duress.

Decision-Making Capacity

Decision-making capacity is often referred to by the legal term competency. It is one of the most important components of informed consent. Decision-making capacity is not black and white. You may have the capacity to make some decisions, but not others.

The components of decision-making capacity are as follows:

  • The ability to understand the options

  • The ability to understand the consequences of choosing each of the options

  • The ability to evaluate the personal cost and benefit of each of the consequences and relate them to your own set of values and priorities

If you are not able to do all of the components, family members, court-appointed guardians, or others (as determined by state law) may act as “surrogate decision-makers” and make decisions for you.

To have decision-making capacity does not mean that you, as the patient, will always make “good” decisions, or decisions that your doctor agrees with. Likewise, making a “bad” decision does not mean that you, as a patient, are “incompetent” or do not have decision-making capacity.

Decision-making capacity, or competency, simply means that you can understand and explain the options, their implications, and give a rational reason why you would decide on a particular option instead of the others.


In order for you to give your informed consent for treatment or tests, the doctor or health care provider must give (or disclose) to you enough information so that you can make an informed decision. It is not necessary or expected that you would receive every detail of the test, treatment, or procedure. You need only the information that would be expected by a reasonable person to make an intelligent decision. This information should include the risks and likelihood (or probability) of each of the risks and the benefits, and likelihood (or probability) of benefit. Any questions you have should be fully explained, in language and terminology that you can understand.

Documentation of Consent

For many tests and procedures, such as routine blood tests, X-rays, and splints or casts, consent is implied. No written documentation of the consent process is obtained. For many invasive tests or for treatments with significant risk, you should be given a written consent form and a verbal explanation, both preferably in your native language. 

The following components should be discussed and included in the written consent form. If they are not, you should request that information:

  • An explanation of the medical condition that warrants the test, procedure, or treatment 

  • An explanation of the purpose and benefits of the proposed test, procedure, or treatment 

  • An explanation or description of the proposed test, procedure, or treatment, including possible complications or adverse events 

  • A description of alternative treatments, procedures, or tests, if any, and their relative benefits and risks 

  • A discussion of the consequences of not accepting the test, procedure, or treatment

The consent form should be signed and dated both by the doctor and by you, as the patient. You would sign for your child. You may ask for a copy of the signed consent form.


Competency is a legal term used to indicate that a person has the ability to make and be held accountable for their decisions. The term is often used loosely in medicine to indicate whether a person has decision-making capacity, as described previously. Technically, a person can only be declared “incompetent” by a court of law.

Informed Consent, The Right to Refuse Treatment

Except for legally authorized involuntary treatment, patients who are legally competent to make medical decisions and who are judged by health care providers to have decision-making capacity have the legal and moral right to refuse any or all treatment. This is true even if the patient chooses to make a “bad decision” that may result in serious disability or even death:

  • To document that you have been given the option of obtaining a recommended treatment or test and have chosen not to, you may be asked to sign an Against Medical Advice (AMA) form to protect the health care provider from legal liability for not providing the disputed treatment. Refusing a test, treatment, or procedure does not necessarily mean that you are refusing all care. The next best treatment should always be offered to anyone who refuses the recommended care.

  • If, because of intoxication, injury, illness, emotional stress, or other reason, a healthcare provider decides that a patient does not have decision-making capacity, the patient may not be able to refuse treatment. The law presumes that the average reasonable person would consent to treatment in most emergencies to prevent permanent disability or death.

  • Advance directives and living wills are documents that you can complete before an emergency occurs. These legal documents direct doctors and other healthcare providers as to what specific treatments you want, or do not want, should illness or injury prevent you from having decision-making capacity.

Clinical Trials and Research

Clinical research trials, or studies, are an important part of healthcare research. They are one of the most important means available to advance the quality of medical care. Clinical studies are often used to determine whether new drugs, procedures, or treatments are safer or more effective than drugs or treatments currently being used.

Enrollment in a clinical study often gives you the opportunity to receive a new drug or treatment before it is widely available. The trade-off is that you may be exposed to risks of the drug or treatment that are not known at the time of the study.

  • In most studies, there is a control group that receives what is considered the current standard of care or best treatment available. One or more experimental groups receive the new treatment.

  • There is usually no cost associated with participation in a study. In some cases, participants may receive payment, medications, tests, or follow-up care at no cost.

  • Informed consent is needed before you may be enrolled in clinical research trials. The purpose of informed consent in this setting is to allow you to learn enough about the study to decide whether or not to participate. Informed consent for a research study (clinical trial) should include the following information:

    • Why the research is being done
    • What the researchers hope to accomplish
    • A description of what will be done during the study and how long you are expected to participate
    • The risks to you from participation in the study
    • The benefits that you can expect from participation in the study
    • Other treatments that are available if you decide not to participate in the study
    • Verification that you have the right to leave the study at any time and that standard medical care will be provided without penalty if you choose to withdraw from the study

  • Although an informed consent document must be signed before enrollment in a study, it is important to remember that informed consent is a process that continues throughout the study. You may ask questions of the health care providers at any time before, during, or after the study. Because deciding whether to participate in a clinical study is an important decision, it is often helpful to discuss the study and the informed consent documents with family members or friends before deciding whether to participate.

Children and Consent

The concept of informed consent has little direct application in children. Although minors may have appropriate decision-making capacity, they usually do not have the legal empowerment to give informed consent. Therefore, parents or other surrogate decision-makers may give informed permission for diagnosis and treatment of a child, preferably with the assent of the child whenever possible.

  • In most cases, parents are assumed to act in the best interest of their child. But circumstances may occur where there is a conflict between what the parents and the health care providers feel is in the best interest. State laws cover some of these areas of potential dispute, for example, in cases of suspected child abuse.
  • Other disagreements in care may result in court orders that specify what treatment should occur (for example, blood transfusions), or in the court-ordered appointment of a guardian to make medical decisions for the child.
  • Most states have laws that designate certain minors as emancipated and entitled to the full rights of adults, including children in these situations:
    • Self-supporting and/or not living at home
    • Married
    • Pregnant or a parent
    • In the military
    • Declared emancipated by a court
  • Most states also give decision-making authority to otherwise unemancipated minors with decision-making capacity (mature minors) who are seeking treatment for certain medical conditions, such as drug or alcohol abusepregnancy, or sexually transmitted diseases.

Here’s the link again from

Print and fill this out when you and your loved ones are well, to ensure you and they have Informed Consent at Hospitals.

If you do not, you will be handed a form to fill out while under duress, and that form gives them the right to use protocols you may not be aware of as it’s difficult to read all the fine print during those times.

Click to access 807523_4fe5cd054a304e26abc95ce29da67d0a.pdf

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INFORMED CONSENT FORMS: Click to access 807523_4fe5cd054a304e26abc95ce29da67d0a.pdf

How To Heal Depression Through Nutrition

One of the best ways to reduce the likelihood of depression is through nutrition.

The following are depression-fighting nutrients that can be obtained through a proper diet and/or supplementation (with medical supervision) by Dr. Pauline Jose.

LA-based Dr. Pauline Jose, the Medical Director at Proactive Health Labs, is a specialist in family medicine, and a clinical instructor at UCLA, Department of Family Medicine. Dr. Jose is an expert in making complex health and health-related topics easy-to-understand and easy for your audience to apply to their daily lives.

Here’s a list of important nutrients your mind needs to thrive:

The following explains benefits, as well as what foods you can find them in. Make sure you’re not deficient in any and stay hydrated with water.

  • Magnesium: Several studies have shown an improvement in the severity of symptoms of depression when study participants were given 125-300 mg of magnesium with each meal and at bedtime. Foods containing magnesium include spinach, pumpkin seeds, yogurt, kefir, almonds, black beans, avocado, figs, dark chocolate and bananas.

  • Chromium: Many studies have been done to assess the benefit of chromium picolinate in depression. One study showed that 70 percent of those who took 600 mcg of chromium picolinate had improvement in their depressive symptoms, including emotional stability. Foods high in chromium include broccoli, free range eggs, sweet potatoes, corn, oats and grass-fed beef.

  • Iron: Decreased levels of iron can result in apathy, depression, and fatigue. Iron is also important for oxygenation of the brain and necessary for all its functions. Iron-rich foods include red meat, pork, poultry, seafoods, beans, spinach (and other leafy greens), peas, cherimoyas, and iron-fortified cereals.

  • Selenium: Depression due to selenium deficiency has been established in at least five different studies. Depression may be the result of oxidative stress, which is why selenium may be helpful. Selenium is a powerful antioxidant. Overall, mood was also improved when selenium was given to those with depleted levels. Foods high in selenium include Brazil nuts, yellowfin tuna, halibut, sardines, and chicken.

  • Zinc: This trace element is essential to the human body. It is involved in over 300 reactions in the body and is abundant in the brain. Zinc supplementation along with antidepressant therapy has been studied and has shown benefits. You can eat lamb, pumpkin seeds, grass fed beef, mushrooms, chickpeas, spinach, and chicken to get more zinc in your daily diet.

  • Copper: This mineral is important in depression because it is a component of the enzymes that metabolize the brain chemicals that help you respond to stress, feel happy and be alert. These enzymes, and the associated chemicals, are responsible for the causes and treatment of anxiety and depression. Copper rich foods include sunflower seeds, lentils, almonds, dark chocolate, beef liver and asparagus.

  • B Vitamins: Deficiencies in various vitamins, including B vitamins are reported to have a negative effect on the brain. There are a total of eight B vitamins. There is a wide range of foods containing B vitamins. If you are vegan or vegetarian, you have to be especially proactive about making sure you get enough B12 (which is mainly found in animal foods).  

  • Vitamin C: Various studies have suggested that depression may be a consequence of inadequate levels of vitamin C. It can usually be found in a variety of fruits and vegetables such as oranges, watermelon, green and red peppers, grapefruit, tomatoes, spinach, papaya, Brussels sprouts, and cabbage.

Being nutritionally balanced puts our bodies in the best position to manage or beat depression. And when you consider being physically active is another way to combat depression, being nutritionally sound enhances our ability to be physically active. 

Be sure to move daily too. The benefits of daily exercise are exceptionally preventative and help elevate your mood naturally. Start with 15-minutes of brisk walking and increase it daily, while incorporating deep breathing. Use music to help pass the time. Your brain and body will benefit.

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Cleveland Clinic Reports Rise In Strokes In Young

May is National Stroke Awareness Month.

Abbas Kharal, MD, a neurologist with Cleveland Clinic, emphasizes it’s a good time to remind people about the signs and symptoms of a stroke and that anyone can have one – even younger people.

“No age group is immune to having strokes, and we’re surprisingly seeing a significant rise in strokes in young adults,” Dr. Kharal said.

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“Particularly in younger adults, we’re seeing a significant rise in premature atherosclerosis, which is hardening and blockages in blood vessels. That is specifically believed to be due to a rise in the vascular risk factors of stroke in more younger patients,” Dr. Kharal said.

“We’re seeing the incidence of high blood pressure, high cholesterol and diabetes occurring now in younger patients in their late 20s into their early 30s. These diseases have traditionally been attributed to a much older population.”

There are several other factors that can lead to stroke, including clotting disorders, structural heart disease, blood vessel abnormalities – including inflammatory and genetic blood vessel disorders – and recreational drug use.

A stroke occurs when there is an issue with blood flow to part of the brain – whether that be due to a lack of blood supply or bleeding in the brain.

Dr. Kharal said it’s important to remember the acronym ‘FAST’ to recognize some of the symptoms of a stroke.

‘F’ is for face drooping, ‘A’ is for arm weakness, ‘S’ is for speech difficulty and ‘T’ is a reminder that it’s time to call 911.

It’s critical to seek immediate medical attention as strokes can cause permanent brain damage or death if treatment is delayed.

What To Do If You Someone Is Having A Stroke:

1. Ask the person to smile. Does one side of the face droop?

2. Ask the person to raise both arms. Does one arm drift downward?

3. Ask the person to repeat a simple phrase. Is their speech slurred or strange?

4. If you observe any of these signs, call 9-1-1 immediately.

According to Dr. Kharal, younger people who experience stroke symptoms will sometimes put off getting help because they think it’s something less serious.

He said lifestyle choices may be one of the reasons why more people under 50 are having strokes.

Dr. Kharal said that living a healthy lifestyle and keeping up with annual doctor visits can reduce a person’s risk of having a stroke.

What Dr. Kharal doesn’t mention is WHY we see a rise in strokes in young people following the rollout of the vaccine. Most of the young people having strokes are otherwise HEALTHY.

These are young people who did not have clotting disorders, structural heart disease, blood vessel abnormalities or inflammatory and genetic blood vessel disorders OR use drugs. Something caused the inflammation, and until they acknowledge that, it will not be prevented.

Pericarditis and Myocarditis are known side effects of the vaccine.

Symptoms of Pericarditis: Sharp, stabbing chest pain that may travel to the left shoulder and neck. It comes on suddenly and can lead to Myocarditis.

Symptoms of Myocarditis: Chest pain felt anywhere in the region of the chest, palpitations where your heart beats particularly fast, malaise or a feeling of uneasiness and discomfort, poor appetite, fever and chills, needing increased effort to breathe, edema which is fluid retention causing your ankles to swell or other areas of your body, physical and mental fatigue and tiredness. Symptoms can last several hours to months.

Myocarditis is inflammation of the heart muscle. It can cause heart failure due to cardiac arrest or dilated cardiomyopathy.

Seek immediate medical attention if you have these symptoms. An MRI can detect Myocarditis. Let your Physician know if and when you were vaccinated.

If yes, make sure they report it.

Difference Between Natural and Safe Beauty Ingredients – And Why It Matters

Everyone deserves fresh, clean, and safe beauty products. From body to hair care, consumers are more mindful than ever of the ingredients in their products – and for good reason. 

Unfortunately, many people have a different idea of clean beauty than industry marketings do. Countless labels boast about their “natural” and “eco-friendly” ingredients – but the truth is that regulations for natural beauty products are still very limited, and these terms can be nearly meaningless. 

This makes it hard to trust beauty brands and their claims, especially when it comes to natural ingredients.

In 2022, many popular dry shampoo products were recalled because they contained unsafe levels of benzene – and many of these items came from brands that supposedly pride themselves on creating safe, eco-friendly products.

So, how can we discern if beauty product ingredients are truly natural and whether or not they’re safe to use? That’s what we want to talk about today. 

Read on to learn more about how to navigate bold marketing claims and find the safe beauty products right for you. 

Natural vs. Safe: What’s the Difference?

When shopping for safe beauty products, you’ll likely see the word “natural” plastered all over. For eco-conscious consumers, this label sounds reassuring – but it’s often deceiving. 

Many consumers are unaware that the beauty and skincare industry is one of the least regulated product sectors in the entire world. It’s all too easy for brands to market their products as “all-natural,” considering there’s no regulatory body checking the accuracy of these claims or making sure the product is safe. 

In fact, many brands will label a product as natural just because it contains mineral or plant-based ingredients. Some brands even label animal byproducts as “natural ingredients,” including things like carmine (crushed-up beetles) or allantoin (cow urine). 

Just recently, Dove was embroiled in the dry shampoo recall, as their product contains benzene – an ingredient that can be formed by natural processes. Benzene has been found to increase your risk of developing cancer – so it’s obviously not a “good” natural ingredient. 

However, the marketing on the Dove website tells a different story. They claim to “find natural ingredients that offer the levels of care for skin and hair that you can expect from a Dove product.” 

Fortunately, we are starting to see changes in federal regulations in regard to beauty labels. The Modernization of Cosmetics Regulation Act of 2022 expanded the FDA’s ability to regulate cosmetic products. This new legislation gives the FDA the ability to recall cosmetic products, access safety records, and require cosmetic brands to create product listings with the FDA. However, this new law still doesn’t fully regulate cosmetic marketing claims. 

Long story short: just because a brand claims to use natural ingredients doesn’t necessarily mean they’re safe to use in the long run. Natural does not equate to trustworthy, clean, or eco-friendly. 

What is Greenwashing?

Deceptive claims like those by Dove are part of a deceptive practice called greenwashing. Dove isn’t the only brand to use greenwashing claims – in fact, these false claims have been sweeping the beauty and skincare industries. 

Greenwashing is a practice that companies use to make their products appear more environmentally friendly or sustainable than they actually are. It involves misleading marketing tactics like eco-friendly buzzwords, symbols, and packaging to create the illusion of being environmentally conscious. 

Unfortunately, many companies that make these claims fail to meet sustainability standards. They may even engage in practices that actively harm the environment. Because greenwashing has become so common, it’s more important than ever to understand the ingredients in your beauty products – and to hold these deceptive brands accountable. 

Consider Shopping for Vegan Beauty Products

If you’re struggling to find safe beauty products you can trust, focus on shopping for vegan beauty brands, rather than “natural.” 

Vegan beauty products don’t contain any ingredients derived from animals. Many non-vegan beauty products have animal ingredients like ground hooves or liver oil hiding in them – probably not things you want to put on your face and body. 

Keep in mind that vegan products aren’t automatically synonymous with being “natural,” as they might still contain man-made chemicals. However, brands committed to using vegan ingredients often have shorter ingredient lists, which makes it easier for you to check these chemicals out.

Most vegan brands also go the extra mile to use sustainable packaging and steer clear of animal testing. While a vegan label doesn’t necessarily guarantee natural ingredients, it does increase your chances of finding a trustworthy brand that prioritizes your safety.  Below are a few familiar brands that do test on animals.

Vegan vs. Cruelty-Free: What’s the Difference?

Many consumers confuse ‘vegan’ and ‘cruelty-free’ labels when shopping for beauty products, but they are distinctly different. Vegan products don’t contain any animal ingredients, while cruelty-free products are not tested on animals. 

Many beauty products are both cruelty-free and vegan. However, it’s possible for a beauty product to fit one or the other of these labels, but not both. Be sure to check for both labels when shopping for beauty products. 

Which Products Are Really Cruelty-Free and Vegan?

It’s often difficult to verify whether your beauty products are cruelty-free or vegan. Unfortunately, the government doesn’t currently require brands to be forthcoming with this information. 

However, there are many ways to actively check a beauty product’s vegan and cruelty-free status. One method is to look for the certified cruelty-free leaping bunny logo on your product labels. 

This logo is managed by the Coalition for Consumer Information on Cosmetics. It is widely used in the US, Canada, China, and many other countries around the world. In order to use this logo, a brand must refrain from animal testing throughout the entire animal testing process. 

Another useful approach is to consult online cruelty-free databases. For example, PETA has a comprehensive database of over 6,000 companies that don’t test on animals.

There are also many mobile apps that have been launched in recent years to provide more information about popular beauty products so you can determine whether or not they’re vegan, cruelty-free, or “clean.” Think Dirty is the most popular of these apps, but other popular options include CosmEthics, Detox Me, and EWG Healthy Living

Final Thoughts

With so many conflicting claims out there, it’s difficult to know which beauty products to trust. This is why it’s so important to do your own research when choosing which beauty products to add to your routine. 

Ultimately, a “natural” label doesn’t necessarily mean a product is safe. Next time you’re shopping for beauty products, be sure to look at the ingredients behind the labels and prioritize other labels that are more trusted.

by Guest Author Michael Ambacher, Chief Operating Officer-General Manager

Mr. Ambacher began his career in the cosmetics business in 1984 with La Costa products working primarily with screen printing, graphic designs, machinery setup and production with a later focus on supply chain management. From 1984-1995 Mr. Ambacher worked in various capacities within the industry including production manager, project manager, warehouse manager, inventory control and purchasing manager giving him a sound foundation of experience. After several years operating his own business, Mr. Ambacher returned to employee status by joining Original Sprout in 2004 as operations manager. Leveraging his previous experience together with formal training at Palomar College and APICS, Mr. Ambacher took on ever increasing responsibilities over the next 13 years resulting in his appointment as COO when Concierge Technologies acquired Original Sprout in 2017. 

An educated consumer is a healthy one.

You can find Cruelty-Free and Vegan hair and skin products at

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RELATED NEWS, MAY 08, 2023 from The Cleveland Clinic

There are all kinds of skin care products available these days – with some focusing on being ‘natural’.

And while you may think those are better for your skin, a study found they often contain allergens.

“Contact dermatitis is a really common issue for people and they develop a really itchy rash,” said Sandra Hong, MD, Chair of Allergy and Clinical Immunology at Cleveland Clinic. “It can be scaly, dry, sometimes blistery, that occurs when we actually come in contact with something our skin is allergic to.”

According to the research, 1,651 so-called ‘natural’ personal care products were studied. Researchers discovered that most of them contained ingredients that can cause allergic contact dermatitis.

Dr. Hong, who did not take part in the study, said products that have fragrances, can be a big culprit.

She recommends people who have very sensitive skin avoid those and use products labeled ‘fragrance free’ or ‘hypoallergenic’ instead.

If you are using a product that is causing contact dermatitis, she recommends stopping immediately. Then, giving it a couple of weeks to see if the skin improves.

“If it doesn’t go away, that would be the time that you would really want to see your doctor to determine if there’s something that you can use to treat it, or to help you figure out what the cause is,” explained Dr. Hong. “Sometimes patients need to go through patch testing to determine the actual cause of their reaction.”

Dr. Hong said it is also important to note the FDA does not approve skincare products before they hit the shelves. So, be sure to look at the ingredients first.