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Informed Consent
Posted 6:18 PM, October 14, 2009, by edurhamConsent to walk over a Mylar blanket? No problem, at least not for me and surely, I thought, not for our teams dream horse the sweet, calm, cooperative, Beau/Orion/ Remy. In my mind it was just a harmless sparkly, blanket. Boy was I wrong!
We began our walk as usual with Beau calm, gentle, and willing, until we got within a few feet of the blanket. The entire expression and motion of this Paint horse changed. He signaled loud and clear how very frightened he was. His eyes widened, ears pointed forward, his nostrils flared, and his feet and body refused to move forward toward the blanket. I thought if I showed him I was calm and walked him forward he would follow. He did not. I tried to be playful and encouraging, he was still terrified by an object I saw as harmless. Nothing I did seemed to help this sweet horse relax or feel any safer. On reflection of our interactions, I believe, I should have gone even slower, no rush in trying to convince Beau to go over the dreaded blanket, to sign his informed consent, so to speak, today. I think for Beau going slower is perhaps the best and fastest way for him to learn and to accomplish this goal.
I know in my work as a healthcare provider, I often ask children or their parents to accept a procedure, a medication, or sign a consent, right now. My interactions with
Beau have allowed me to better understand that something I perceive to be harmless, routine, or needed might, in fact, be incredibly stressful or frightening; even though I do not perceive it as such. I will be more mindful of this as I work with children and their families.
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Comment by: Tamara at October 19, 2009 12:19 PM
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I was part of the dream team, and this exercise taught me so much about understanding doctor-patient tactics and also about unvoiced patient fears. By working with such a large animal, as a horse, I realized how easy it is for adults to impose their will as a last resort on children and smaller animals. For example, if a child doesn't want to take his or her flu shot, then fine, restrain the child for his or her own good. In comparison, it doesn't work as easily with a horse! I felt incredibly self conscious and mindful of Remy's feelings, as our team tried all sorts of ways to coax, force, and push the horse to achieve a simple task.