Rules and Regulations of the State of Georgia
 

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If you are an entitled government entity pursuant the Georgia Administrative Procedures Act, <a target="_new" href="http://links.casemakerlegal.com/states/GA/books/Code_of_Georgia/browse?ci=25id=gasos&amp;codesec=50-13-7&amp;title=50&amp;#50-13-7(d)">O.C.G.A.§ 50-13-7(d)</a> contact the State of Georgia's Administrative Procedures Division at 678-364-3785 to enable these features for your location.)</p> <p>To access this website, you must agree to the following: </p> <p> These terms of use are a contract between you and/or your employer (if any), and Lawriter, LLC. </p> <p> You agree that you will not copy, print, or download anything from this website for any commercial use. </p> <p> You agree not to use any web crawler, scraper, or other robot or automated program or device to obtain data from the website.</p> <p> You agree that you will not sell, will not license, and will not otherwise make available in exchange for anything of value, anything that you download, print, or copy from this site.</p> <p> You agree that you will not copy, print, or download any portion of the regulations posted on this site exceeding a single chapter of regulations for sale, license, or other transfer to a third party, except that you may quote a reasonable portion of the regulations in the course of rendering professional advice.</p> <p> If you violate this agreement, or if you access or use this website in violation of this agreement, you agree that Lawriter will suffer damages of at least $20,000. </p> <p> THIS WEBSITE AND ITS CONTENT ARE PROVIDED "AS IS." 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If you are an entitled government entity pursuant the Georgia Administrative Procedures Act, <a target="_new" href="http://links.casemakerlegal.com/states/GA/books/Code_of_Georgia/browse?ci=25id=gasos&amp;codesec=50-13-7&amp;title=50&amp;#50-13-7(d)">O.C.G.A.§ 50-13-7(d)</a> contact the State of Georgia's Administrative Procedures Division at 678-364-3785 to enable these features for your location.)</p> <p>To access this website, you must agree to the following: </p> <p> These terms of use are a contract between you and/or your employer (if any), and Lawriter, LLC. </p> <p> You agree not to use any web crawler, scraper, or other robot or automated program or device to obtain data from the website. </p> <p> You agree that you will not sell or license anything that you download, print, or copy from this website.</p> <p> THIS WEBSITE AND ITS CONTENT ARE PROVIDED "AS IS." 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charset=UTF-16"> </HEAD> <div id="infobar"><a href="javascript:;" accesskey="r" Name="Route" title="Route" class="quickkey"><em class="mnemonic">R</em>oute </a>:<div class="searchtips" style="float:right;margin-right:10px;color: rgb(47, 79, 79);"> <a style="text-decoration:none;color: rgb(47, 79, 79);" title="search tips" name="searchtip" href="../help.aspx#searching" target="_blank"><em class="mnemonic">S</em>earch tips</a></div><ul class="breadcrumb"> <li><a href="/GAC" name="GAC" title="GAC">GA R&amp;R</a></li> <li>&raquo; <a href="/GAC/360" title="360">Department 360</a></li> <li>&raquo; Chapter 360-14</li> </ul> </div> </div><div id="doc" class="container"> <div id="doc-content" class="content"> <h1><nllchapter>Chapter 360-14 INFORMED CONSENT</nllchapter></h1> <h2><a href="/GAC/360-14-.01" name="360-14-.01" title="360-14-.01">Rule 360-14-.01 Purpose; Effective Date</a></h2> <P>The purpose of these rules is to establish the standards for physician compliance with and the standards necessary to implement Code Section 31-9-6.1 of the Official Code of Georgia Annotated (O.C.G.A.) including enforcement thereof through disciplinary action, and to inform all physicians who possess licenses to practice medicine in the State of Georgia of the enactment of said legislation by the General Assembly of the State of Georgia, which will become effective on January 1, 1989, and which will apply to surgical or diagnostic procedures subject to the statutory requirements performed on or after January 1, 1989. These rules will be enforceable and effective January 1, 1989.</P> <h2><a href="/GAC/360-14-.02" name="360-14-.02" title="360-14-.02">Rule 360-14-.02 Definitions</a></h2> <P>As used in this Chapter:</P> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.02(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Contrast materials" means a non-physiologically occurring molecular compound used to produce density differences in tissues, organs, or vessels to permit visualization of the imaging of such internal bodily structures.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.02(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Direct orders" means orders directly given by or communicated by the responsible physician to persons under the direct or immediate supervision or control of the responsible physician and for whose acts there are direct or immediate responsibility.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.02(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Emergency" means a situation, as defined in Code Section <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=31-9-3&amp;title=31#" target="_newtab">31-9-3</a>, wherein: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.02(3)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> According to competent medical judgments, the proposed major surgical or diagnostic procedures are reasonably necessary; and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.02(3)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A person authorized to consent under Code Section <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=31-9-2&amp;title=31#" target="_newtab">31-9-2</a> is not readily available; and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.02(3)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Any delay in treatment could reasonably be expected to jeopardize the life or health of the person affected or could reasonably result in disfigurement or impaired faculties.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.02(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "General anesthesia" means a state of unconsciousness and insensitivity to pain affecting the entire body which is produced by the administration of an intramuscular, intravenous or inhalant anesthetic.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.02(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Intravenous injection" means the injection of a substance directly into a vein.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.02(6)">(6)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Likelihood" means the degree or probability of success or failure expressed in general terms or in percentages.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.02(7)">(7)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Major region" means entire arm, leg, torso, or any combination thereof.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.02(8)">(8)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Major regional anesthesia" means a state of insensitivity to pain affecting a major region of the body which is produced by the temporary interruption of the sensory nerve conductivity of such a region through the administration of a spinal, epidural, intravenous regional, or brachial plexus anesthetic.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.02(9)">(9)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Major surgical or diagnostic procedures" means any surgical procedure under general anesthesia, spinal anesthesia, or major regional anesthesia or an amniocentesis diagnostic procedure or a diagnostic procedure which involves the intravenous injection of a contrast material.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.02(10)">(10)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Material risk" means a material risk generally recognized and accepted by reasonably prudent physicians of infection, allergic reaction, severe loss of blood, loss or loss of function of any limb or organ, paralysis or partial paralysis, paraplegia or quadraplegia, disfiguring scar, brain damage, cardiac arrest, or death which could result from the major surgical or diagnostic procedure and which, if disclosed to a reasonably prudent person in the patient's position, could reasonably be expected to cause such prudent person to decline the major surgical or diagnostic procedure on the basis of material risk of injury that could result from the major surgical or diagnostic procedure.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.02(11)">(11)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Medical personnel" means persons under the direct supervision and control of the responsible physician who are duly licensed or authorized to participate in the performance of a major surgical or diagnostic procedure or who are otherwise involved in the course of treatment of the patient's condition.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.02(12)">(12)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Practical alternatives" means practical alternatives to a major surgical or diagnostic procedure which are generally recognized and accepted by reasonably prudent physicians.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.02(13)">(13)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Responsible physician" means the physician who performs the major surgical or diagnostic procedure or the physician under whose direct orders the major surgical or diagnostic procedure is performed by a nonphysician.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.02(14)">(14)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Spinal anesthesia" means a state of insensitivity to pain which is produced by the temporary interruption of the sensory nerve conductivity of a major region of the body through the injection of an anesthetic into the subarachnoid space.</td> </tr> </table> <h2><a href="/GAC/360-14-.03" name="360-14-.03" title="360-14-.03">Rule 360-14-.03 Requirement of Consent for Major Surgical and Diagnostic Procedures</a></h2> <P>Except as otherwise provided in Code Section 31-9-6.1 and these rules, and in particular the exceptions outlined in Code Section 31-9-6.1(e), a person who undergoes any of the following surgical or diagnostic procedures to be performed on or after January 1, 1989, must consent to such procedure as outlined in said Code Section and these rules:</P> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.03(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Any surgical procedure under general anesthesia, spinal anesthesia or major regional anesthesia;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.03(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> An amniocentesis diagnostic procedure;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.03(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A diagnostic procedure which involves the intravenous injection of a contrast material.</td> </tr> </table> <h2><a href="/GAC/360-14-.04" name="360-14-.04" title="360-14-.04">Rule 360-14-.04 Information Required to be Disclosed; Means of Disclosure</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.04(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Except as otherwise provided in Code Section 31-9-6.1 and these rules, a person who undergoes a major surgical or diagnostic procedure shall be informed in general terms of each of the following: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.04(1)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The diagnosis of the patient's condition requiring such proposed surgical or diagnostic procedure;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.04(1)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The nature and purpose of such proposed surgical or diagnostic procedure;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.04(1)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The material risks of such proposed procedure as defined in Board Rule <a title="360-14-.02(10)" href="360-14-.02#360-14-.02(10)">360-14-.02(10)</a>;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.04(1)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The likelihood of success of such proposed surgical or diagnostic procedure;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.04(1)(e)">(e)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The practical alternatives to such proposed surgical or diagnostic procedure; and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.04(1)(f)">(f)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The prognosis of the patient's condition if such proposed surgical or diagnostic procedure is rejected.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.04(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The information required to be disclosed pursuant to Code Section 31-9-6.1(a)(1)through(6) and these Rules may be disclosed through any one or all of the following means: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.04(2)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Video tapes;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.04(2)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Audio tapes;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.04(2)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Pamphlets;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.04(2)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Booklets;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.04(2)(e)">(e)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Other means of communication; or</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.04(2)(f)">(f)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Conversations with the responsible physician, other physicians, physician's assistants, nurses, trained counselors, patient educators or other similar persons known by the responsible physician to be knowledgeable and capable of communicating such information.</td> </tr> </table> </td> </tr> </table> <h2><a href="/GAC/360-14-.05" name="360-14-.05" title="360-14-.05">Rule 360-14-.05 Standards for Physicians Compliance, Sanctions for Noncompliance</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.05(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.05(1)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> When a responsible physician is required to ensure that consent to a major surgical or diagnostic procedure is obtained and that certain information is provided in connection therewith, such requirement shall have been complied with if accomplished through the use of the form set forth in Exhibit A attached to this Rule or through the use of a form which is substantially similar to such form or which includes provisions substantially similar to such form.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.05(1)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> When a responsible physician is required to ensure that consent to a major surgical or diagnostic procedure is obtained and that certain information is provided in connection therewith, such requirement shall be rebuttably presumed to have been complied with if evidenced in writing signed by the patient or other person authorized to sign for the patient.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.05(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The failure to obtain the written consent to a major surgical or diagnostic procedure shall not cause such consent and the provision of information in connection therewith to be invalid but no presumption as to the validity of such consent shall arise.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.05(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Any physician who fails to comply with these rules shall be subject to disciplinary action under Code Chapter 43-34, and Chapter 360-3 of the Rules of the Georgia Composite Medical Board.</td> </tr> </table> <h2><a href="/GAC/360-14-.06" name="360-14-.06" title="360-14-.06">Rule 360-14-.06 Exceptions to Disclosure and Consent Requirements</a></h2> <P>The disclosure of information and the consent required by these rules shall not be required in connection with a major surgical or diagnostic procedure if:</P> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.06(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> An emergency exists as defined in Code Section <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=31-9-3&amp;title=31#" target="_newtab">31-9-3</a>;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.06(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The surgical or diagnostic procedure is generally recognized by reasonably prudent physicians to be a procedure which does not involve a material risk to the patient involved;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.06(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A patient or other person(s) authorized to give consent pursuant to Code Chapter 31-9, make(s) a request in writing that the information provided for in Code Section <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=31-9-6.1&amp;title=31#" target="_newtab">31-9-6.1</a> not be disclosed or utilizes the form set forth in Exhibit B to this Rule or any other form which is substantially similar to such form or which include(s) provisions substantially similar to such form;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.06(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A prior consent, within thirty (30) days of the surgical or diagnostic procedure, complying with the requirements of these rules has been obtained as a part of a course of treatment for the patient's condition; provided, however, that if such consent is obtained in conjunction with the admission of the patient to a hospital for the performance of such procedure, the consent shall be valid for a period of thirty (30) days from the date of admission or for the period of time the person is confined in the hospital for that purpose, whichever is greater; or</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="360-14-.06(e)">(e)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The surgical or diagnostic procedure was unforeseen or was not known to be needed at the time the consent was obtained, and the patient has consented to allow the responsible physician to make the decision concerning such procedure.</td> </tr> </table> <h2><a href="/GAC/Exhibit(360-14) A" name="(360-14) A" title="(360-14) A">Exhibit (360-14) A CONSENT TO SURGICAL OR DIAGNOSTIC PROCEDURES</a></h2> <P> DO NOT SIGN THIS FORM WITHOUT READING AND UNDERSTANDING ITS CONTENTS</P> <P> Name of Patient______________________ Date________________ </P> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="(360-14) A(A)">(A)</a></td> <td valign="top" style="text-align:left" class="leftalign"> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="(360-14) A(A)(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> I acknowledge and understand that the following procedure(s) which has (have) been described to me is (are) to be performed on the patient: __________________________________________________________ __________________________________________________________ __________________________________________________________ and that as a result of the performance of the procedure(s) there is a material risk that the patient may suffer infection, allergic reaction, severe loss of blood, loss or loss of function of any limb or organ, paralysis or partial paralysis, paraplegia or quadraplegia, disfiguring scar, brain damage, cardiac arrest, or death.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="(360-14) A(A)(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> I acknowledge and understand that during the course of the procedure(s) described in subparagraph (A) (1) above, conditions may develop which may reasonably necessitate an extension of the original procedure(s) or the performance of procedure(s) which are unforeseen or not known to be needed at the time this consent is obtained. I therefore consent to and authorize the persons described in the last paragraph of this consent to make the decisions concerning the performance of and to perform such procedure(s) as they may deem reasonably necessary or desirable in the exercise of their professional judgment, including those procedures that may be unforeseen or not known to be needed at the time this consent is obtained. This consent shall also extend to the treatment of all conditions which may arise during the course of such procedures including those conditions which may be unknown or unforeseen at the time this consent is obtained.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="(360-14) A(B)">(B)</a></td> <td valign="top" style="text-align:left" class="leftalign"> I acknowledge and understand and duly evidence in writing by executing this form that I have been informed in general terms of the following: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="(360-14) A(B)(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A diagnosis of the condition requiring the procedure(s);</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="(360-14) A(B)(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The nature and purpose of the procedure(s);</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="(360-14) A(B)(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The material risks of the procedure(s) (see paragraph (A) above);</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="(360-14) A(B)(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The likelihood of success of the procedure(s);</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="(360-14) A(B)(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The practical alternatives to such procedure(s); and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="(360-14) A(B)(6)">(6)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The prognosis if the procedure(s) is (are) rejected; and that such was provided through the use of video tapes, audio tapes, pamphlets, booklets, or other means of communication or through conversations with the responsible physician, or other medical personnel under the supervision and control of the responsible physician, other medical personnel involved in the course of treatment, nurses, physician's assistants, trained counselors, or patient educators.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="(360-14) A(C)">(C)</a></td> <td valign="top" style="text-align:left" class="leftalign"> I acknowledge that there are practical alternatives to the procedure(s) described in paragraph (A) which alternatives reasonably prudent physicians generally recognize and accept.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="(360-14) A(D)">(D)</a></td> <td valign="top" style="text-align:left" class="leftalign"> I acknowledge and understand that this request for and consent to surgical or diagnostic services shall be valid for the responsible physician, all medical personnel under the direct supervision and control of the responsible physician, and for all other medical personnel otherwise involved in the course of treatment. I HAVE BEEN GIVEN AMPLE OPPORTUNITY TO ASK QUESTIONS AND ANY QUESTIONS I HAVE ASKED HAVE BEEN ANSWERED OR EXPLAINED IN A SATISFACTORY MANNER. <P> BY SIGNING BELOW, I ACKNOWLEDGE I HAVE READ OR HAD IT READ OR EXPLAINED TO ME AND I UNDERSTAND THIS FORM AND I VOLUNTARILY CONSENT TO ALLOW DR._____________ OR ANY PHYSICIAN DESIGNATED OR SELECTED BY HIM OR HER AND ALL MEDICAL PERSONNEL UNDER THE DIRECT SUPERVISION AND CONTROL OF SUCH PHYSICIAN AND ALL OTHER PERSONNEL WHICH MAY OTHERWISE BE INVOLVED IN PERFORMING SUCH PROCEDURES TO PERFORM THE PROCEDURES DESCRIBED OR OTHERWISE REFERRED TO HEREIN.</P> <P> ____________________ </P> <P>Witness</P> <P>____________________________________</P> <P> Signature of patient or other person authorized to sign</P> </td> </tr> </table> <h2><a href="/GAC/Exhibit(360-14) B" name="(360-14) B" title="(360-14) B">Exhibit (360-14) B </a></h2> <P>CONSENT TO SURGICAL OR DIAGNOSTIC PROCEDURES AND WAIVER OF RIGHT TO RECEIVE INFORMATION IN CONNECTION THEREWITH</P> <P> DO NOT SIGN THIS FORM WITHOUT READING AND UNDERSTANDING ITS CONTENTS.</P> <P> Name of Patient___________________________ Date___________</P> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="(360-14) B(A)">(A)</a></td> <td valign="top" style="text-align:left" class="leftalign"> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="(360-14) B(A)(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> I acknowledge and understand that the following' procedure) which has (have) been described to me is (are) to be performed on the patient: <P>________________________________________________</P> <P>________________________________________________</P> <P>________________________________________________</P> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="(360-14) B(A)(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> I acknowlege and understand that during the course of the procedure(s) described in subparagraph (A) (1) above, conditions may develop which may reasonably necessitate an extension of the original procedure(s) or the performance of procedure(s) which are unforeseen or not known to be needed at the time this consent is obtained. I therefore consent to and authorize the persons described in the last paragraph of this consent to make the decisions concerning the performance of and to perform such procedure(s) as they may deem reasonably necessary or desirable in the exercise of their professional judgment, including those procedures that may be unforeseen or not known to be needed at the time this consent is obtained. This consent shall also extend to the treatment of all conditions which may arise during the course of such procedures including those conditions which may arise during the course of such procedures including those conditions which may be unknown or unforeseen at the time this consent is obtained.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="(360-14) B(B)">(B)</a></td> <td valign="top" style="text-align:left" class="leftalign"> I acknowledge and understand and duly evidence in writing by executing this form that under Georgia law I am entitled to receive the following information relative to the procedure(s) described in paragraph (A): <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="(360-14) B(B)(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A diagnosis of the condition requiring the procedure(s);</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="(360-14) B(B)(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The nature and purpose of the procedure(s);</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="(360-14) B(B)(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The material risks of the procedure(s);</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="(360-14) B(B)(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The likelihood of success of the procedure(s);</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="(360-14) B(B)(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The practical alternatives to such procedure(s);</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="(360-14) B(B)(6)">(6)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The prognosis if the procedure(s) is (are) rejected.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="(360-14) B(C)">(C)</a></td> <td valign="top" style="text-align:left" class="leftalign"> I acknowledge that there are practical alternatives to the procedure (s) described in paragraph (A) which alternatives reasonably prudent physicians generally recognize and accept.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="(360-14) B(D)">(D)</a></td> <td valign="top" style="text-align:left" class="leftalign"> I acknowledge and understand that this request for and consent to surgical or diagnostic services shall be valid for the responsible physician, all medical personnel under the direct supervision and control of the responsible physician, and for all other medical personnel otherwise involved in the course of treatment. <P> I HAVE BEEN GIVEN AMPLE OPPORTUNITY TO ASK QUESTIONS AND ANY QUESTIONS I HAVE ASKED HAVE BEEN ANSWERED OR EXPLAINED IN A SATISFACTORY MANNER.</P> <P> BY SIGNING BELOW, I ACKNOWLEDGE I HAVE READ OR HAD IT READ OR EXPLAINED TO ME AND I UNDERSTAND THIS FORM AND I VOLUNTARILY CONSENT TO ALLOW DR. __________________OR ANY PHYSICIAN DESIGNATED OR SELECTED BY HIM OR HER AND ALL MEDICAL PERSONNEL UNDER THE DIRECT SUPERVISION AND CONTROL OF SUCH PHYSICIAN AND ALL OTHER PERSONNEL WHICH MAY OTHERWISE BE INVOLVED IN PERFORMING SUCH PROCEDURES TO PERFORM THE PROCEDURES DESCRIBED OR OTHERWISE REFERRED TO HEREIN AND I FULLY AND COMPLETELY WAIVE THE RIGHT TO BE INFORMED OF THE INFORMATION SPECIFIED IN PARAGRAPH (B) AND REQUEST THAT SUCH INFORMATION NOT BE DISCLOSED.</P> <P> _____________________________________________</P> <P> Witness</P> <P> _____________________________________________</P> <P>Signature of patient or other person authorized to sign</P> </td> </tr> </table> </div> </div> </HTML> </div> <div id="toc" class="sidebar noprint"> <ul id="toc-children" class="children"><li><a href="/GAC/360-14-.01" name="360-14-.01" title="360-14-.01">Rule 360-14-.01 Purpose; Effective Date</a></li><li><a href="/GAC/360-14-.02" name="360-14-.02" title="360-14-.02">Rule 360-14-.02 Definitions</a></li><li><a href="/GAC/360-14-.03" name="360-14-.03" title="360-14-.03">Rule 360-14-.03 Requirement of Consent for Major Surgical and Diagnostic Procedures</a></li><li><a href="/GAC/360-14-.04" name="360-14-.04" title="360-14-.04">Rule 360-14-.04 Information Required to be Disclosed; Means of Disclosure</a></li><li><a href="/GAC/360-14-.05" name="360-14-.05" title="360-14-.05">Rule 360-14-.05 Standards for Physicians Compliance, Sanctions for Noncompliance</a></li><li><a href="/GAC/360-14-.06" name="360-14-.06" title="360-14-.06">Rule 360-14-.06 Exceptions to Disclosure and Consent Requirements</a></li><li><a href="/GAC/Exhibit(360-14) A" name="(360-14) A" title="(360-14) A">Exhibit (360-14) A CONSENT TO SURGICAL OR DIAGNOSTIC PROCEDURES</a></li><li><a href="/GAC/Exhibit(360-14) B" name="(360-14) B" title="(360-14) B">Exhibit (360-14) B </a></li></ul> </div> </div> <!--content ends here--> <div id="footer" class="noprint"><span class="footer">Copyright &copy; 2019 Lawriter LLC - All rights reserved.</span>| <a href="mailto:support@casemakerlegal.com?subject=Rules and Regulations of the State of Georgia">Email Us</a> | 844-838-0769 | <a href="http://livechat.casemakerlegal.com/client.php?locale=en" target="_blank" onclick="if(navigator.userAgent.toLowerCase().indexOf('opera') != -1 && window.event.preventDefault)window.event.preventDefault();this.newWindow = window.open('http://livechat.casemakerlegal.com/client.php?locale=en&url='+escape(document.location.href)+'&referrer='+escape(document.referrer), 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