Informed Consent

Presented by: James Demetrious, DC, DABCO

Important Disclaimer – NCMIC Offers the Following Insight

Doctors need to understand that informed consent is a process that may or may not be satisfied with a written form. It is the doctor’s responsibility to ensure that the patient is properly informed, understands, and consents to the treatment to be provided. However, it is also within the doctor’s discretion as to how the information is communicated and how the consent is obtained. Specific state statutes or case laws often further define the necessary elements to establish informed consent. Because of the possible peculiarities in any given state, we believe that doctors of chiropractic would be best served by contacting an attorney in their state who practices healthcare-related law and asking that person to advise the doctor regarding their particular practice.

What is Informed Consent

Generally, the legal concept informed consent arises from the principle that absent extenuating circumstances, a patient has the right to exercise control over his or her body by making an informed decision concerning whether to consent to a particular course of treatment or procedure. For the patient to truly consent it is generally held that they should know and completely understand the following:

  1. Nature of the treatment to be rendered;
  2. All material risks attendant to that treatment;
  3. The possibility of an occurrence of the risks;
  4. Alternative treatment available and the risks attendant to those treatments;
  5. The consequences of allowing the condition to remain untreated.

State Laws and Jurisdiction

It is vitally important that physicians comply with the regulatory mandates established in their jurisdiction. As an example, I offer the guidelines established in my home state by the North Carolina Board of Chiropractic Examiners:

  • A chiropractic physician is legally and ethically obligated to obtain informed consent from his patient prior to the start of treatment.
  • Consent cannot be considered informed unless, at a minimum, the physician orally explains the risks associated with the proposed course of treatment, answers any questions the patient may have, and obtains the patient’s permission to treat.
  • The physician shall note in the patient’s clinical record the date of the informed consent consultation, the matters discussed, and the authorization to treat given by the patient.
  • A standardized form may be used only as a written acknowledgment by the patient that the consultation occurred and that consent was given.
  • A form cannot replace the face-to-face discussion between physician and patient contemplated by this guideline.
  • If the patient is a minor or an incompetent adult, the informed consent consultation shall include the patient’s parent or legal guardian.

In Practice

On a daily basis, doctors receive important clinical information from new and existing patients. This information provides the doctor with the clues necessary to make recommendations, offer a course of action, and render treatment. Patient–doctor discussions and informed consent occur throughout the day with each patient visit. There is an infinite number of possible clinical circumstances that cannot be covered entirely in every patient encounter. We inform patients to the best of our ability.

In addition to direct discussions with patients, I offer the following document in my office that covers some of the expectations, risks, and benefits of my care. I am certain that this document can be improved upon and suggest that you consult with your legal representative to be assured that it meets your needs.

It is important to note that the below document:

  • Does not establish a standard of care.
  • It is intended for consideration and discussion.
  • Doctors should consult with legal counsel to meet the requirements of their jurisdiction.

For further insight and to advance yourself as a physician, please take advanced coursework at:

PostGradDC coursework is:

  • PACE recognized for license renewal.
  • Current, evidence-based, highly referenced, and practical.
  • Applicable to the NCMIC Malpractice discount.
  • Written by an internationally distinguished chiropractic orthopedist.


The views and opinions expressed in this presentation are solely those of the author. NCMIC does not set practice standards. We offer this only to educate and inform.

PostGradDC offers advanced post-graduate chiropractic continuing education. Our founder, Dr. James Demetrious, is an internationally distinguished board-certified chiropractic orthopedist, educator, author, and editor. For current, evidence-based, and clinically intuitive CE Coursework, attain your advanced training at