IMPLIED CONSENT and
INFORMED CONSENT
It’s the law!!
What is Implied Consent?
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During the first visit (or first visit of
a new complaint or condition), the
doctor must gather information
about that patient
The doctor must take a case history
and must perform necessary
examinations
By the patient’s presence in the
office, consent for the
EXAMINATIONS is IMPLIED
IMPLIED CONSENT
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Therefore, by the patient’s presence
in your office, you do not need to
obtain written permission to
perform necessary examinations
Verbal consent to perform exam is
all that is needed for most
situations (in DC offices)
IMPLIED CONSENT
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He or she is automatically giving you
permission for
informationgathering only
The patient has NOT given the doctor
permission to perform any
interventions/treatments/therapies (i.e.
an adjustment)
Obviously, exceptions apply when the
situation is critical (ER, EMT)
Questions about IMPLIED CONSENT?
INFORMED CONSENT
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It is both a process and paperwork
Informed consent begins after the
doctor has gathered all necessary
information and has determined the
necessary intervention
INFORMED CONSENT
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The doctor must give the
information he or she knows that
may play a role in the patient’s
decision about his or her health or
health care choices
INFORMED CONSENT
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There are 5 important elements of
the informed consent process:
1. Diagnosis/Clinical Impression
Patient wants to know:
“What is wrong with me?”
 This must be given in understandable
terms

INFORMED CONSENT
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2. Treatment/Intervention

The patient wants to know:
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“Can you help me?”
This is NOT the time to explain the
exact technique of adjusting or
biomechanics of adjusting. One
explains how chiropractic can help
with the particular diagnosis from
element #1
INFORMED CONSENT
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3. Risks or complications associated
with the treatment or with the
diagnosis
In some states, you are required to
explain in writing
For example, you must give lifting
restrictions to a patient with an
acute disc herniation
INFORMED CONSENT
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4. Alternative treatments,
concurrent treatments, or additional
diagnostic procedures
This is the time to tell the patient if
more treatments or tests are
needed (either within or outside of
your office)
INFORMED CONSENT
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5. Successes and Failures
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The patient wants to know:
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“What is my prognosis?”
This information is based upon
personal experiences of the doctor,
literature, research, classroom
knowledge
INFORMED CONSENT
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So, by informing the patient of the 5
elements, you have completed the process
of INFORMED CONSENT
By having the patient sign the form, you
have completed the paperwork part of
INFORMED CONSENT
Remember, though, that if the patient’s
condition or complaints change, or you
must change your clinical impression, you
must repeat INFORMED CONSENT
IS THIS FOR PALMER ONLY?
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You must utilize an informed
consent process for every patient in
your office
What if you do not inform a patient
prior to an adjustment (or any form
of treatment)?
What about minors?
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In Iowa and Illinois, care of any
patient under the age of 18 requires
the consent of a parent or a legal
guardian
The parent or legal guardian is
required to be present on the first
visit
TWO RULES
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Additionally, there are two rules
associated with informed consent
that you should be aware of:
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The Doctor’s Rule
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The Patient’s Rule
The Doctor’s Rule
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In ALL states, the Doctor’s Rule
applies:
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The doctor determines what
information is important to deliver to
the patient.
Example: Kidney stone
The Patient’s Rule
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In SOME states, the Patient’s Rule
applies:
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The doctor must give any and all information
to the patient in order for him or her to make
an informed decision about his or her health
care options
Example: Kidney stone
It is not a rule that the patient must tell the
doctor everything about the complaint