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New informed consent forms in Ohio


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I was at the doctors yesterday. While waiting in the room I saw some ready great informed consent documents. They are lengthy so I’ll only put in a few lines. I know we have a very long way to go but it’s something.

 

One is controlled substance patient and provider agreement for  benzodiazepines and sleep aids such as lunesta. Patient have to initial each line. Many are risks:

 

1. Addiction. This means I could get an uncontrolled craving to use these medications. Even if I take them as prescribed.

 

2. Physical dependency. This means I could have symptoms of withdrawal if I suddenly stop taking the medications.

 

3. Tolerance. This means that over time, my provider may need to increase my dose to get the same effect.

 

4. Taking sleep aids with benzodiazepines together may cause death by stopping my breathing.

 

5. Misuse of these medications, such as taking more than prescribed, or taking them with alcohol or illegal drugs, or other medications that have not been prescribed to me may hurt or kill me.

 

6. These medications may make me feel dizzy or sleepy and slow to react. These could cause an  accident in my home or if I’m driving I might hurt myself or others. These medications may also affect my ability to make important decisions.

 

Other side effects include:

 

Common

 

Confusion

Feeling dizzy

Feeling sleepy

Headache

Lacking energy

Muscle aches

Stuffy nose

Sleep related eating

 

Serious

 

Addiction

Physical dependence

Tolerance

 

Life threatening

Trouble breathing

Thoughts of killing yourself

Coma

Death.

 

 

They also have the same sheets for lyrica, antidepressants and soma. The hospital facilities will not prescribe Soma as they feel it is too addictive.

 

There are other parts the patient must initial about what the doctors can do including my prescribing medication or no refills and the patients will get random drug tests.

 

It’s a good start, I think.

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But for most patients, the reasoning will still go something like this:

  • If the doctor prescribes them, they must not be that dangerous.
  • If they were that dangerous, the doctor wouldn't prescribe them.
  • Those warnings are just legalese from the lawyers and insurance companies.
  • I'll be all right if I take them as prescribed.
  • I trust my doctor.

 

I'm afraid those "informed consent" forms are all about protecting the doctors and hospitals and drug companies - and not the patients.

And you really have to wonder how valid the patients' consent is, given their mental state and the doctors' influence.

If the patients were really capable of making these decisions on their own, there would be no need for prescriptions.

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Years ago I was given Mirtazipine. The leaflet said ‘may cause loss of consciousness, coma and death. If this occurs please contact a Dr urgently’ or something like that. Hilarious.

Still put it in my mouth.

It made me pass out cold so never took it again.

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But for most patients, the reasoning will still go something like this:

  • If the doctor prescribes them, they must not be that dangerous.
  • If they were that dangerous, the doctor wouldn't prescribe them.
  • Those warnings are just legalese from the lawyers and insurance companies.
  • I'll be all right if I take them as prescribed.
  • I trust my doctor.

 

I'm afraid those "informed consent" forms are all about protecting the doctors and hospitals and drug companies - and not the patients.

And you really have to wonder how valid the patients' consent is, given their mental state and the doctors' influence.

If the patients were really capable of making these decisions on their own, there would be no need for prescriptions.

 

 

There was a lot more to those forms that I put down. I said so. I also believe it’s not perfect. But like I said, it’s a start. I think that’s quite a stretch to say no need for prescriptions. Like in decades past, you could buy opiates off the shelves? See how well that went? I have some older friends who for decades got addicted to opiates by picking them up as OTC products. I said the forms Indicated that they won’t prescribe if they feel the patient is not in need. It’s just a start! Lawyer or not.

 

Red if you were required to read and sign that you are okay with the addictive dangers of benzos, would you have taken them? If you would have then you deserve to be here.

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But for most patients, the reasoning will still go something like this:

  • If the doctor prescribes them, they must not be that dangerous.
  • If they were that dangerous, the doctor wouldn't prescribe them.
  • Those warnings are just legalese from the lawyers and insurance companies.
  • I'll be all right if I take them as prescribed.
  • I trust my doctor.

 

I'm afraid those "informed consent" forms are all about protecting the doctors and hospitals and drug companies - and not the patients.

And you really have to wonder how valid the patients' consent is, given their mental state and the doctors' influence.

If the patients were really capable of making these decisions on their own, there would be no need for prescriptions.

 

 

There was a lot more to those forms that I put down. I said so. I also believe it’s not perfect. But like I said, it’s a start. I think that’s quite a stretch to say no need for prescriptions. Like in decades past, you could buy opiates off the shelves? See how well that went? I have some older friends who for decades got addicted to opiates by picking them up as OTC products. I said the forms Indicated that they won’t prescribe if they feel the patient is not in need. It’s just a start! Lawyer or not.

 

Red if you were required to read and sign that you are okay with the addictive dangers of benzos, would you have taken them? If you would have then you deserve to be here.

 

You are not reading what I wrote. I said, IF patients were capable of making those decisions on their own, THEN there would be no need for prescriptions. Now, IF is a very important qualifier. When you see it, you should pay attention to it, and not ignore it and go on a rant. The reason we have prescriptions is precisely because lay people ARE NOT capable of making these decisions on their own. That's why physicians are required to have a certain medical education, to pass certain examinations, and to be licensed: so that they WILL BE CAPABLE of making those medical judgments that lay people ARE NOT capable of making. Are you seeing these qualifications yet, benzogirl? Or do I have to write more slowly for you?

 

As for whether or not I deserve to be here, I am not a bit surprised that you would make such a comment. But still, I think it's beneath contempt.

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Red

 

I saw the if part. To me it doesn’t matter because the hospital system is forcing them to read and sign the forms. You always tend to make people sound stupid and incapable of anything. There are people like this but by and large they are in the minority. I for one would never have taken these psych drugs had a been allowed to read these. That’s the thing—-it’s a point by point explanation of the dangers of a variety of psych drugs. I can assure you the vast majority of members here would never have taken their benzo. You are dumbing down the members here.

 

The bigger picture is why are they drugs allowed to be prescribed? That’s for a different day. I am very happy about these informed consent forms. Do you have them where you live? I would be happy if you did. Am I writing too fast for you? I always felt you were a nasty member of this forum and while you seem to have some friends you also have many who can’t stand you. It’s people like you who I can’t stand and thus take very long breaks from here. I try to post something positive only to get shot down. You are a condescending person. Stick to Spanish please. I know I won’t be here for eight years. I have a life.

 

No te molestes en responder ya terminé aquí.

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Benzogirl,

 

I think these forms, like you said, are a great start.  I don’t believe that most of us are helpless babbling idiots when we go into a doctor’s office and are completely incapable of reading and understanding forms we are asked to initial that describe the dangers associated with the psyche drugs listed.  Although this is not the perfect end all solution to the problem, it is definitely a step in the right direction.

 

Sofa

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I see some great information here, I agree, anything which will draw more attention to the dangers of any drug is a good thing, however I also feel we've been programmed to believe if we don't leave a Dr's office without a script, we're not getting our money's worth.  How many times have you heard someone gripe because their Dr wouldn't give them an antibiotic when they asked for it, even though their infection was viral not bacterial?  And then there are the commercials on TV advertising drugs and the warnings which drone on in a hushed voice about all of the dangers, we don't care, we want them anyway because that won't happen to me.

 

As I said, any recognition of the dangers of all drugs is a good thing, so I'm grateful for this post and the discussion that follows.  However, the personal attacks need to stop, they disrupt the thread and are not productive.

 

 

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I'd like to see a similar form initialed by the doctor taking some responsibility as the person writing the prescriptions. Perhaps they would be a little less likely to polydrug people if they were held responsible.
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Messedup,

 

Good idea.  Unfortunately, doctors probably want to avoid putting any responsibility for the risks of drugs on their shoulders.  Perhaps some sort of consumer advocacy group has a form that would provide protection for patients, or at least some notion of dual responsibility.

 

Sofa

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These forms are a ruse. They're intended to paper over the cracks in the status quo: not to change it, but to maintain it. In fact, they make the situation worse. They will be used against the patient, not against the doctors or the drug companies.

 

 

With these forms, the doctors are in effect saying this:

You have now read about all the many dangers and horrible side-effects of these drugs.

Do you still want to take them?

Check yes or no, and then sign here (so our lawyers will have this when you sue us).

 

And here's how most patients, in effect, will respond to the doctors:

You are also aware of all the dangers and side-effects of these drugs,

but you still choose to prescribe them.

So I guess you don't really think the risk is that great.

And you know a lot more about medicine than I know.

So I guess it will be ok to take them.

 

Maybe it's not the patients who should be signing these forms. Maybe it's the doctors.

 

 

Most or all of these warnings about the dangers of these drugs are already contained in the package inserts, and yet patients continue to use these drugs, because they trust their doctors. Patients waiting to see their doctors for anxiety and depression are seldom in the right mental, emotional, or educational state to assume responsibility for "choosing" to use these drugs. They are there because the doctors have expertise that the patients lack. This does not make them babbling idiots. This just makes them computer programmers or engineers or accountants or project managers or musicians rather than medical doctors.

 

These so-called informed consent forms attempt to shift responsibility away from the doctors, and onto the patients. Just imagine how and where such consent forms will be used.  Imagine that some patients have been harmed by these drugs, and they manage to find some lawyer willing to sue the prescribing doctors for malpractice. What do you suppose the doctors will produce in their defense? These informed consent forms, of course. Their lawyers will say this:

 

You see? These patients were told about all the dangers, and still they freely and knowingly consented to taking these drugs.

 

And then, to the jury, the lawyers will make some contemptible remark along these lines:

 

.. if you were required to read and sign that you are okay with the addictive dangers of benzos, would you have taken them? If you would have then you deserve to be here.

 

There is no conceivable way these informed consents could ever be used by the injured patients against the prescribing doctors. It's all the other way around. It's all designed to protect the doctors - who are actually making the decisions about the appropriate treatment, because they are the ones with the medical expertise. Don't ever let yourself believe that any form drafted by doctors (and their lawyers) is intended to protect the patients. That is never the case.

 

When some very intelligent and accomplished non-babbling-idiot Nobel laureate patient comes in to tell the doctor about their depression and anxiety, their insomnia, their thoughts of self-harm, their obsessional thinking, their impaired mental functioning, their rages and crying fits - is that actually the right time for the doctor to toss a pile of legal documents in front of them and ask them to decide whether or not they want to use this or that medication? There seems to be some disagreement about that here.

 

We've seen all this before, in the area of workplace injuries. Before the present workers' compensation system, people injured on the job were routinely barred from monetary compensation on the grounds that they consented to working there, knowing the dangers. They assumed the risk of injury. Before being hired, they would often be required to sign forms acknowledging the risks of the job and assuming full responsibility for these risks. After all, they were responsible adults, and not babbling idiots, so how could they say that the employer was to blame? And yada yada yada, on and on.

 

It was all nonsense, of course, because we were dealing with people who would not be hired anywhere, by anyone, unless they consented to the risk of workplace injury. That was the informed consent of the American workplace back then, before the New Deal replaced all that with workers compensation.

 

I'm not someone who always looks for some new legal regulation to solve every new problem. I usually prefer to allow consenting adults to make their own arrangements with each other, whether in the boardroom or the bedroom. But there are situations where people are not actually able to protect themselves properly, where they need legal regulations to protect them. This is especially true of people who are debilitated physically, mentally, and emotionally, and who are being mistreated by someone who has a fiduciary responsibility towards them. The law needs to step in here. The FDA and other "consumer protection" agencies (what a joke!) need to be called to task for their failure to protect the patients. These informed consent forms are just a diversion.

 

And again, we need to ask the doctors who give these warnings to their patients: if these drugs have all these risks, why are you still prescribing them?

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@[ R...]

-may my poor brain aspire to such future heights.. lol

 

***

Written from the perspective of my particular journey..

 

This idiot actually knew the risks, or perhaps more the problems, but arrogantly, my prior experience with what limited meds I had had in life, -was that they did nothing “Noticeable” anyways... (outside of a theatre/ER type setting)

 

Seriously, I used to laugh to myself at people taking some sort of “pain med” to get high recreationally..!!  :(

 

Looking back these 10yrs..  Its very clear to me that the moments that impacted my decisions as to the dangers of these serious meds, was when a Dr that I had a “trusting” relationship with, developed over time, made mention of it.. It was often a way too casual comment too, and not really “news” to me, -So yeah, I had to be open to hearing it, I guess...

 

Sadly, in most situations it seems, a TRUE Dr/Patient relationship is not part of the current model...

-To say the least..!!

And the higher up one goes the worse it can get, -for so many reasons beyond the Dr themselves, more the environ within which they work..

Asides a private trauma team from Germany, my best, -and it has been good, Doctoring has come from my “Family” Dr, a GP...  She has walked beside me in many ways... Available time, and perhaps not such a singular modality of experience..??

 

Sorry, probs a bit off track (my speciality), But perhaps as I felt Red alludes to, this might be more a modern society/economic/liability issue..  -And I best not go there..!!

:)

 

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Don't ever let yourself believe that any form drafted by doctors (and their lawyers) is intended to protect the patients. That is never the case.

 

And again, we need to ask the doctors who give these warnings to their patients: if these drugs have all these risks, why are you still prescribing them?

 

Thanks Evan....you nailed it IMO.  :thumbsup:

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I agree with both sides of this discussion.  What now? 

 

People on this forum have always complained about the fact they were not given the opportunity of informed consent.  Now that Benzogirl just mentioned she was finally given this opportunity, people are shooting down her optimism that informed consent will only protect and benefit the prescribing doctors.

 

For five years I have read hundreds of posts from members bemoaning NO INFORMED CONSENT.  Has everyone who is agreeing with Redevan always believed informed consent was bullshit?  I am not disagreeing with anything Redevan has said.  I just wonder now if there is any solution at all to this problem—unless the solution is, well, just stop prescribing these meds.  Yeah, that’s gonna happen.

 

So is the solution that there is none?

 

Sofa

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Of course these forms are a ruse and in the best interest of doctors. I never denied it. But please don’t throw the baby out with the bath water. Each of you must ask yourself if you read five pages that talk about the dangers of these drugs would you ever have popped one?

 

If the informed consent documents just help one person out of a thousand, they are well worth it. Of course this is just a start and we all have a long way to go as do doctors, hospital systems and the FDA. And Big Pharma.

 

Speaking of which, has it ever occurred to you that since this forum is the go to place for benzo tapering support and is very popular among us, you must realize that pharma knows all about it and my guess doesn’t approve. They don’t want a public face from the pain people suffer because of benzos. Colin is no match for the myriad of lawyers and billions if dollars. While Colin has done us all a tremendous favor with his time and money, if they put the squeeze on him and threaten him with legal action, how long will he fight this and instead say it’s not worth it? Just like so many other sites have disappeared. Pharma doesn’t have to win, just pile  tons of paperwork until he or we are simply out lawyered. Putting disclaimers in won’t do the trick.

 

Pharma can’t fight a simple taper plan or even a dry micro taper.  But if you change the chemistry via vodka or PG, they may have a point. I honestly worry about the future here and am glad I got so much help when needed. I’m off and don’t need the help anymore. As you know the health care system in America is a mess that is run by Pharma. Sad but true.

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Idk..?? -I, myself, just responded to a (1, one) post within the thread..

:)

 

Its not like I ever sat in a Drs office and discussed the pros n cons of starting a psych med... -I “woke up” in the trenches... Thus I was cautious with what aspects I mentioned..  Mine was more a race against dependancy.. -An epic fail..!!

 

But I keep coming back to why, if the Drs are the prescribing experts, with the final yay or nay decision, why is it coming back on the patient to decide, -consent to harm or not.. -A simplistic view, im sure...

 

:)

 

 

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But I keep coming back to why, if the Drs are the prescribing experts, with the final yay or nay decision, why is it coming back on the patient to decide, -consent to harm or not.. -A simplistic view, im sure...

 

:)

 

Precisely. Its just a means of having it "both ways"... either way the patient end up being the "responsible party".

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The bigger issue is that the reality is that doctors will likely continue to poo-poo the dangers. How else are they going to get people to take the stuff they are prescribing?

 

I heard "I'm not worried about the with YOU" when I asked my doctor about benzos causing problems and when I asked about taking PPI's long term- "The reason why they say you should only take them for two weeks is because they don't want patients diagnosing themselves" which I later found out is utter BS, PPIs can cause huge issues if taken long term.

 

TRUE informed consent involves the PRESCRIBING DOCTOR VERBALLY WARNING their patients of the dangers of said drugs. Not handing them a sheet of paper to sign and then downplaying the dangers when asked for clarification.

 

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The bigger issue is that the reality is that doctors will likely continue to poo-poo the dangers. How else are they going to get people to take the stuff they are prescribing?

 

I heard "I'm not worried about the with YOU" when I asked my doctor about benzos causing problems and when I asked about taking PPI's long term- "The reason why they say you should only take them for two weeks is because they don't want patients diagnosing themselves" which I later found out is utter BS, PPIs can cause huge issues if taken long term.

 

TRUE informed consent involves the PRESCRIBING DOCTOR VERBALLY WARNING their patients of the dangers of said drugs. Not handing them a sheet of paper to sign and then downplaying the dangers when asked for clarification.

 

:thumbsup:

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What about informed consent associated with w/d'g from benzos? Most if not all long-term benzo patients on BB are familiar with benzo withdrawal syndrome and the long lasting or perhaps permanent debilitating symptoms associated with w/d'g from benzos.

 

I am familiar with some State mandated informed consent regulations for starting/continuing the use of controlled substances but, I have not seen or heard of any informed consent regulations for the discontinuation of controlled substances ... why is that?

 

 

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FI,

 

Yes, this is a huge issue.  The WITHDRAWAL is never addressed.  The TAKING is. 

 

Like everyone has pointed out, informed consent is a “cover the doctor’s ass” legalese tool.  My issue was how I’ve read so many posts where members feel they never would have taken the drugs in the first place had they been given informed consent.  Truthfully, like most people, I am sitting in a room with a doctor and THAT’S who I’m listening to.  All the forms in the world would not have replaced the trust I put in his education and license.  Informed consent would probably have done little or nothing to deter me. 

 

What a mess this all is.  Mostly because we are human.

 

Sofa

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I would have paid more attention if I had to sign such a form.

 

Still, a "risk" of dependence seems like the wrong choice of words. It is certainly a guarantee? Am I wrong? I don't know what the criteria are for proving that a substance causes dependence.

 

Thank you for sharing this info.

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