Saturday, May 18, 2019

NIH: Informed consent "NEEDED" for "most vaccines", AND PATIENTS HAVE THE RIGHT TO REFUSE

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While the legislature has gone mad, fueled by fake news and Pharma largesse, forgotten are our minimum, legal standards that guarantee informed consent and prevent US patients from being forced to comply with vaccinations and other medical procedures.  

Interestingly, the NIH has not forgotten we have this right.

Informed consent - adults

You have the right to help decide what medical care is best for you. By law, your health care providers must explain your health condition and treatment choices to you.
Informed consent means:
  • You are informed. You have received information about your health condition and treatment options.
  • You understand your health condition and treatment options.
  • You are able to decide what health care treatment you want to receive and give your consent to receive it.
To obtain your informed consent, your provider may talk with you about the treatment. Then you will read a description of it and sign a form. This is written informed consent.
Or, your provider may explain a treatment to you. They will ask if you agree to have the treatment. Not all medical treatments require written informed consent.

What Treatments Need Informed Consent?

Medical procedures that may require you to give written informed consent include:
  • Most surgeries, even when they are not done in the hospital
  • Other advanced or complex medical tests and procedures, such as an endoscopy (placing a tube down your throat to look at the inside of your stomach) or a needle biopsy of the liver
  • Radiation or chemotherapy to treat cancer
  • Most vaccines
  • Some blood tests, such as HIV testing (need for written consent varies by state)

What Should Occur During the Informed Consent Process?

When asking for your informed consent, your doctor or other health care provider must explain:
  • If treatment is necessary now or if it can wait
  • Your health problem and the reason for the treatment
  • What happens during the treatment
  • The risks of the treatment and how likely they are to occur
  • How likely the treatment is to work
  • Other options for treating your health problem
  • Risks or possible side effects that may happen later on
You should have enough information to make a decision about your treatment. Your provider should also make sure you understand the information. One way a provider may do this is by asking you to repeat the information back in your own words.
If you would like more details about your treatment choices, ask your provider where to look. There are many trusted websites and other resources your provider can give you.

What is Your Role in the Informed Consent Process?

You are an important member of your health care team. You should ask questions about anything you do not understand. If you need your provider to explain something in a different way, ask them to do so.
You have the right to refuse treatment if you are able to understand your health condition, your treatment options, and the risks and benefits of each option. Your doctor or other health care provider may tell you they do not think this is the best choice for you. But, your providers should not try to force you to have a treatment you do not want to have.
It is important to be involved in the informed consent process. After all, you are the one who will receive the treatment if you give your consent.

Other Tips

Informed consent is not needed in an emergency when delayed treatment would be dangerous.
Some people are no longer able to make an informed decision, such as someone with advanced Alzheimer disease or someone in a coma. In both cases, the person would not be able to understand information to decide what medical care they want. In these types of situations, the provider would try to obtain informed consent for treatment from a surrogate, or substitute decision-maker.
Even when your provider does not ask for your written consent, you should still be told what tests or treatments are being done and why. For example:
  • Before they have the test, men should know the pros, cons, and the reasons for a PSA blood test that screens for prostate cancer.
  • Women should know the pros, cons, and the reasons for a Pap test, a mammogram, or other tests.
  • Anyone who is being tested for an infection that occurs after sexual contact should be told about the test and why they are being tested.


Emanuel EJ. Bioethics in the practice of medicine. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 2.
United States Department of Health and Human Services website. Informed consent. Accessed January 2, 2018.

Review Date 11/20/2017

Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Thursday, May 9, 2019

Meryl Nass, MD's medical practice

I am a board-certified internal medicine doctor.  I graduated with a degree in biology from MIT, attended NJ Medical School and the University of Mississippi Medical School. I have practiced in Maine since 1997.  

I am passionate about improving the lives of my patients.  I try to find the least toxic methods of treatment for each individual.  I use medicines, supplements, diets, and other healing modalities, as needed, for tough clinical problems like chronic fatigue syndrome, chronic lyme disease and fibromyalgia. 

I believe in First, Do No Harm.  My goals are 1) to use a minimum of medications and avoid iatrogenic (doctor-caused) harms, and 2) answer all my patients' questions as thoroughly as possible.  

I opened a medical practice because there were no local physicians treating chronic, complex disorders like Lyme--despite the large number of affected patients.  (According to the CDC, Maine has the highest rate of reported Lyme cases, per person, in the US.  Hancock County, where I practice, has the highest rate of Lyme in Maine.)

In order to make this practice work, I cannot accept any insurance plans, and patients must pay for my services when services are rendered. While some insurance plans will reimburse patients for the cost of visits, other (including Medicare) do not.

I hope to see patients with challenging disorders, those who wish to reduce their medications and/or use diet and lifestyle changes to improve health, and those with illnesses occurring after tick bites, fibromyalgia-related, or occurring as a consequence of military service or anthrax vaccine.  In my opinion, Lyme and tick-borne diseases should be considered in every patient with an undiagnosed illness.  Tick-borne diseases have taken a large and varied toll on our community. 

I also treat the range of illnesses seen in primary care internal medicine.  

The office phone number is (207) 610-5885.  The fax number is 610-5886.
The office address is 210 Main Street, Ellsworth, Maine, 04605.  My cell (for emergencies) is (207) 522-5229.  My email address is  I do see patients evenings and weekends, if needed for acute illnesses, and can be reached by email as needed.