Medical ‘informed consent’ should include actual price
Is it ethical to perform a service for someone without a good faith estimate of what you’re going to charge? Usually service providers know exactly what they’re getting: money. The customer, on the other hand, is usually receiving a service he doesn’t fully understand. Since the sellers have expertise in the service, they may have a duty to disclose certain information to the buyer. This could be anything from a restaurant noting menu items that could trigger allergies, to an attorney explaining the risks of a particular trial strategy.
Doctors have wrapped this concept into their ethical duty to patients: They must give patients enough information to make an informed choice regarding their medical care. Only when the patient understands the risks can a doctor receive “informed consent” to proceed with treatment. A general practitioner shouldn’t prescribe medicine without discussing possible side effects. A surgeon can’t operate without describing the risks. But currently, the cost of treatment is not part of the information required for a patient to consent.
Since most people haven’t gone to medical school, doctors are better positioned than their patients to understand the risks. But only the patient can properly weigh the risks and rewards for their situation. So, it is incumbent on the doctor to provide the patient with this information. Only then can a patient make an informed decision.
Similarly, only the patient is qualified to weigh the financial costs of medical care against the likely benefits. Someone on a doctor’s staff is best positioned to convey price information to the patient. But most doctors and hospitals do not recognize an ethical duty to give their patients this good faith estimate of their out-of-pocket expenses. The ethical depravity of giving someone the runaround before a procedure and then sending them multiple bills after the fact ought to make every doctor’s skin crawl.
Informed consent should include price as a matter of course. The Legislature and the courts each have at their disposal the means to correct this glaring omission in the medical ethical code. Or doctors could correct it themselves. They could insist that their patients not be blindsided by surprise billing. It’s the right thing to do.