How should a chiropractor handle informed consent changes?

• A. Update documentation to reflect changes and obtain new informed consent when treatment plans change.
• B. Do nothing; consent remains the same.
• C. Notify the board but skip patient consent.
• D. Update records but never obtain fresh consent.

Answer: (A)

Informed consent is an ongoing process, not a single event. When a chiropractor changes the treatment plan, new information, risks, benefits, and alternatives may be relevant, so the patient must be informed again and explicitly agree to the revised plan. This means clearly explaining what is changing, why the change is made, potential risks or downsides of the new approach, any alternatives, and the expected benefits. The patient’s understanding and voluntary agreement should be documented in the medical record with a fresh consent form and the date of the discussion.

This approach is the best because it respects patient autonomy, ensures the patient is aware of new risks or changes in the course of care, and provides a clear record that the patient consented to the updated plan. Simply doing nothing leaves the patient with outdated information and unclear authorization. Notifying the board without obtaining patient consent bypasses the patient’s right to decide, and updating records without obtaining fresh consent does not demonstrate that the patient agreed to the new plan.