CLE Informed Consent Process 3 — Questions and Answers
Question 1: A client with a history of breast surgery asks about breastfeeding. What informed consent obligation does the CLE have?
- Assure her that breastfeeding is always possible after surgery
- Disclose how surgery may affect milk production and explain monitoring strategies (Correct answer)
- Refer her directly to a physician without providing any information
- Proceed with standard lactation education without mentioning surgery
Correct answer: Disclose how surgery may affect milk production and explain monitoring strategies
The CLE must disclose how prior breast surgery can affect lactation so the client can make an informed decision about breastfeeding goals and monitoring.
Question 2: Which of the following best describes 'therapeutic privilege' in the context of informed consent?
- The provider's right to withhold information if they believe it will harm the client (Correct answer)
- The client's right to waive disclosure of information they do not wish to receive
- The legal protection providers receive when clients refuse recommended care
- The obligation to disclose all information regardless of client preferences
Correct answer: The provider's right to withhold information if they believe it will harm the client
Therapeutic privilege refers to withholding information deemed potentially harmful to the client, though it is ethically controversial and rarely justified.
Question 3: A teen mother wants lactation support, but her parent insists on being the sole decision-maker. How should the CLE proceed?
- Defer entirely to the parent as the legal guardian for all decisions
- Assess the minor's legal status and involve her in consent to the extent permitted by law (Correct answer)
- Provide care without consent since the parent is present
- Refuse to provide care until the teen turns 18
Correct answer: Assess the minor's legal status and involve her in consent to the extent permitted by law
CLEs must understand that mature minor doctrine and state laws may grant adolescents the right to consent to their own reproductive and lactation-related care.
Question 4: What is a key difference between consent for a research study and consent for standard clinical lactation education?
- Research consent requires IRB oversight and disclosure of study purpose and risks (Correct answer)
- Clinical consent requires IRB approval while research consent does not
- Research participants have fewer rights than clinical clients
- Standard clinical consent always requires witness signatures
Correct answer: Research consent requires IRB oversight and disclosure of study purpose and risks
Research consent requires IRB oversight and explicit disclosure of research nature, potential risks, voluntary participation, and the right to withdraw without penalty.
Question 5: A CLE recommends a specific breastfeeding position. The client declines, preferring a different position. What is the appropriate response?
- Insist on the recommended position because it has the best evidence
- Respect the client's refusal and explore her preferred position while educating about safety (Correct answer)
- Document refusal and discontinue the visit
- Contact the client's physician to override her preference
Correct answer: Respect the client's refusal and explore her preferred position while educating about safety
Clients have the right to refuse specific recommendations, and the CLE should respect autonomy while providing education about all relevant considerations.
Question 6: When documenting informed consent in the medical record, what is the minimum that should be recorded?
- Only the client's signature on a standardized form
- What information was discussed, client's demonstrated understanding, and voluntary agreement (Correct answer)
- The CLE's assessment of the client's decision-making capacity only
- Date and time of the visit with a note that consent was obtained
Correct answer: What information was discussed, client's demonstrated understanding, and voluntary agreement
Documentation should reflect the content discussed, evidence of comprehension, and the client's voluntary agreement to support the validity of consent.
Question 7: A client agrees to try a supplemental nursing system (SNS). Two days later she changes her mind. What should the CLE do?
- Remind her she already gave consent and agreed to the plan
- Honor her withdrawal of consent and explore her concerns and alternative options (Correct answer)
- Require her to complete a formal refusal-of-care document before changing the plan
- Contact the referring physician before making any changes to the care plan
Correct answer: Honor her withdrawal of consent and explore her concerns and alternative options
Informed consent is an ongoing process, and clients retain the right to withdraw consent and change their care plan at any time.
CLE Informed Consent Process 3
A client with a history of breast surgery asks about breastfeeding.
What informed consent obligation does the CLE have?