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August 1989, Vol 143, No. 8 >
Article | August 1989

Informed Consent for Lumbar Puncture FREE

Jeffrey R. Botkin, MD, MPH
[+] Author Affiliations

Accepted for publication April 20, 1989.

Reprints not available.


Am J Dis Child. 1989;143(8):899-904. doi:10.1001/archpedi.1989.02150200051016.
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• Informed consent procedures are commonly employed prior to lumbar puncture. An understanding of the legal and ethical basis of informed consent is important in developing an acceptable approach to consent and in dealing with problems confronted when consent cannot be obtained. I review the current legal concepts in informed consent and their ethical foundation, and make recommendations to clinicians for obtaining consent for this common procedure in the ambulatory pediatric population.

(AJDC. 1989;143:899-904)

REFERENCES

1 +
Faden RR, Beauchamp TL. A History and Theory of Informed Consent . New York, NY: Oxford University Press Inc; 1986;.
2 +
Applebaum PS, Lidz CW, Meisel A. Informed Consent: Legal Theory and Clinical Practice . New York, NY: Oxford University Press Inc; 1987;.
3 +
Katz J. The Silent World of Doctor and Patient . New York, NY: Free Press; 1984;.
4 +
The President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. Making Health Care Decisions . Washington, DC: US Government Printing Office; 1982;.
5 +
Schloendorff v Society of NY Hospital, 211 NY 125,105 NE 92(1914).
6 +
 The law of informed consent. The President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research . Making Health Care Decisions . Washington, DC: US Government Printing Office; 1982;;3:201-202.
7 +
Salgo v Leland Stanford Jr University Board of Trustees, 317 P2d 170,181 (1957).
8 +
Faden RR, Beauchamp TL. A History and Theory of Informed Consent . New York, NY: Oxford University Press Inc; 1986;:23-49.
9 +
Cobbs v Grant, 104 Cal Rptr 505,502 P2d 1 at 11(1972).
10 +
Applebaum PS, Lidz CW, Meisel A. Informed Consent: Legal Theory and Clinical Practice . New York, NY: Oxford University Press Inc; 1987;:175-189.
11 +
Grundner TM.  On the readability of surgical consent forms . N Engl J Med . 1980;;302:900-902.
12 +
Mariner WK, McArdle PA.  Consent forms, readability, and comprehension: the need for new assessment tools . Law Med Health Care . 1985;; 13:68-74.
13 +
Sard v Hardy, 379 A2d 1014(1977).
14 +
Boisaubin EV, Dresser R.  Informed consent in emergency care: illusion and reform . Ann Emerg Med . 1987;;16:62-67.
15 +
Leikin SL.  Minor's assent or dissent to medical treatment. In: The President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research . Making Health Care Decisions . Washington, DC: US Government Printing Office; 1982;;3:175-191.
16 +
Goldstein J.  Medical care for the child at risk: on state supervention of parental autonomy . Yale Law J . 1977;;86:645-670.
17 +
Custody of a Minor, Mass, 393 NE 2d 836 (1979).
18 +
Re Vasco, 238 App Div 128, 263 NYS 552 (1933).
19 +
Jehovah's Witnesses of Washington King County Hospital, 278 F Supp 488 (Washington, DC 1967), affirmed per curiam 390 US 598 (1968).
20 +
Re Green, Pa, 292 A2d 387 (1972).
21 +
In the Matter of Seiferth, 127 NE 2d 820 (1955).
22 +
Williams JC. Power of court or other public agency to order medical treatment for child over parental objections not based on religious grounds. 97 ALR 3d 421 (1980).
23 +
 The President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research . Deciding to Forgo Life-Sustaining Treatment . Washington, DC: US Government Printing Office; 1983;:215-217.
24 +
American Academy of Pediatrics Committee on Bioethics.  Religious exemptions from child abuse statutes . Pediatrics . 1988;;81:169-171.
25 +
Klein JO, Feigin RD, McCracken GH.  Report of the task force on diagnosis and management of meningitis . Pediatrics . 1986;;78( (suppl) ):977.
26 +
Herson VC, Todd JK.  Prediction of morbidity in Hemophilus influenza meningitis . Pediatrics . 1977;;59:35-39.
27 +
Marton KI, Gean AD.  The spinal tap: a new look at an old test . Ann Intern Med . 1986;;104:840-848.
28 +
Ruff RL, Dougherty JH.  Evaluation of acute cerebral ischemia for anticoagulant therapy: computed tomography or lumbar puncture . Neurology . 1981;;31:736-740.
29 +
Teele D, Dashevsky B, Rakusan T, Klein JO.  Meningitis after lumbar puncture in children with bacteremia . N Engl J Med . 1981;;305:1079-1081.
30 +
Shapiro ED, Aaron NH, Wald ER, Chiponis D.  Risk factors for development of bacterial meningitis among children with acute bacteremia . J Pediatr . 1986;;109:15-19.
31 +
Dodge PR, Swartz MN.  Bacterial meningitis: a review of selected aspects . N Engl J Med . 1965;;272:898-902,954-960, 1003-1010.
32 +
Horowitz SJ, Boxerbaum B, O'Bell J.  Cerebral herniation in bacterial meningitis in childhood . Ann Neurol . 1980;;7:524-528.
33 +
Addy DP.  When not to do a lumbar puncture . Arch Dis Child . 1987;;62:873-875.
34 +
Richards PG, Towu-Aghantse E.  Dangers of lumbar puncture . Br Med J . 1987;;292:605-606.

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References

1 +
Faden RR, Beauchamp TL. A History and Theory of Informed Consent . New York, NY: Oxford University Press Inc; 1986;.
2 +
Applebaum PS, Lidz CW, Meisel A. Informed Consent: Legal Theory and Clinical Practice . New York, NY: Oxford University Press Inc; 1987;.
3 +
Katz J. The Silent World of Doctor and Patient . New York, NY: Free Press; 1984;.
4 +
The President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. Making Health Care Decisions . Washington, DC: US Government Printing Office; 1982;.
5 +
Schloendorff v Society of NY Hospital, 211 NY 125,105 NE 92(1914).
6 +
 The law of informed consent. The President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research . Making Health Care Decisions . Washington, DC: US Government Printing Office; 1982;;3:201-202.
7 +
Salgo v Leland Stanford Jr University Board of Trustees, 317 P2d 170,181 (1957).
8 +
Faden RR, Beauchamp TL. A History and Theory of Informed Consent . New York, NY: Oxford University Press Inc; 1986;:23-49.
9 +
Cobbs v Grant, 104 Cal Rptr 505,502 P2d 1 at 11(1972).
10 +
Applebaum PS, Lidz CW, Meisel A. Informed Consent: Legal Theory and Clinical Practice . New York, NY: Oxford University Press Inc; 1987;:175-189.
11 +
Grundner TM.  On the readability of surgical consent forms . N Engl J Med . 1980;;302:900-902.
12 +
Mariner WK, McArdle PA.  Consent forms, readability, and comprehension: the need for new assessment tools . Law Med Health Care . 1985;; 13:68-74.
13 +
Sard v Hardy, 379 A2d 1014(1977).
14 +
Boisaubin EV, Dresser R.  Informed consent in emergency care: illusion and reform . Ann Emerg Med . 1987;;16:62-67.
15 +
Leikin SL.  Minor's assent or dissent to medical treatment. In: The President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research . Making Health Care Decisions . Washington, DC: US Government Printing Office; 1982;;3:175-191.
16 +
Goldstein J.  Medical care for the child at risk: on state supervention of parental autonomy . Yale Law J . 1977;;86:645-670.
17 +
Custody of a Minor, Mass, 393 NE 2d 836 (1979).
18 +
Re Vasco, 238 App Div 128, 263 NYS 552 (1933).
19 +
Jehovah's Witnesses of Washington King County Hospital, 278 F Supp 488 (Washington, DC 1967), affirmed per curiam 390 US 598 (1968).
20 +
Re Green, Pa, 292 A2d 387 (1972).
21 +
In the Matter of Seiferth, 127 NE 2d 820 (1955).
22 +
Williams JC. Power of court or other public agency to order medical treatment for child over parental objections not based on religious grounds. 97 ALR 3d 421 (1980).
23 +
 The President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research . Deciding to Forgo Life-Sustaining Treatment . Washington, DC: US Government Printing Office; 1983;:215-217.
24 +
American Academy of Pediatrics Committee on Bioethics.  Religious exemptions from child abuse statutes . Pediatrics . 1988;;81:169-171.
25 +
Klein JO, Feigin RD, McCracken GH.  Report of the task force on diagnosis and management of meningitis . Pediatrics . 1986;;78( (suppl) ):977.
26 +
Herson VC, Todd JK.  Prediction of morbidity in Hemophilus influenza meningitis . Pediatrics . 1977;;59:35-39.
27 +
Marton KI, Gean AD.  The spinal tap: a new look at an old test . Ann Intern Med . 1986;;104:840-848.
28 +
Ruff RL, Dougherty JH.  Evaluation of acute cerebral ischemia for anticoagulant therapy: computed tomography or lumbar puncture . Neurology . 1981;;31:736-740.
29 +
Teele D, Dashevsky B, Rakusan T, Klein JO.  Meningitis after lumbar puncture in children with bacteremia . N Engl J Med . 1981;;305:1079-1081.
30 +
Shapiro ED, Aaron NH, Wald ER, Chiponis D.  Risk factors for development of bacterial meningitis among children with acute bacteremia . J Pediatr . 1986;;109:15-19.
31 +
Dodge PR, Swartz MN.  Bacterial meningitis: a review of selected aspects . N Engl J Med . 1965;;272:898-902,954-960, 1003-1010.
32 +
Horowitz SJ, Boxerbaum B, O'Bell J.  Cerebral herniation in bacterial meningitis in childhood . Ann Neurol . 1980;;7:524-528.
33 +
Addy DP.  When not to do a lumbar puncture . Arch Dis Child . 1987;;62:873-875.
34 +
Richards PG, Towu-Aghantse E.  Dangers of lumbar puncture . Br Med J . 1987;;292:605-606.

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