Informed Consent

I was in the midst of an intense academic period during my master’s program when I received a call—my father had fallen and hit his head. Details were scarce, but he was in an ambulance on the way to the hospital, and the caller thought I should know because I was his healthcare proxy.

As more information trickled in, I learned that he had suffered a brain bleed. The only way to treat it was to wait until his system cleared Warfarin, an anticoagulant he had been taking due to prior health issues. He had also lost consciousness and was being kept alive by machines. There was no question—I had to get on a plane immediately and travel 2,000 miles from Rochester, New York, to Phoenix, Arizona, where my father lived.

When I arrived, the doctors told me it was a race against time. Would his Warfarin levels drop quickly enough to allow a procedure that could prevent permanent damage?

Despite the doctors’ best efforts, my father didn’t make it. His brain injury, compounded by the delay in treatment due to the Warfarin, proved too severe. As I navigated the heartbreak of losing him, I couldn’t help but reflect on the overwhelming responsibility of being his healthcare proxy. I was forced to make life-altering decisions with limited medical knowledge, relying entirely on the information provided by the doctors.

Throughout this ordeal, I learned firsthand about informed consent—the ethical and legal obligation physicians have to ensure that patients (or, in my case, their healthcare proxies) receive and fully understand all relevant medical information, including risks, benefits, alternatives, and potential consequences.

The Catch with Informed Consent

Despite the good intentions behind informed consent, there are two major challenges:

1. Lack of Medical Expertise – Unless you are a medical professional, you don’t have the benefit of four years of medical school, three to seven years of residency, and years of hands-on experience. This knowledge gap makes it difficult to fully grasp the implications of complex medical decisions.
2. Optimism Bias – As patients or family members, we naturally focus on the positive and downplay the negative. We want to believe the best-case scenario and minimize risks in our minds.

The Impact of Optimism Bias

Optimism bias occurs when people overestimate the likelihood of positive outcomes while underestimating risks. For example, a patient might hear all the benefits of surgery but mentally downplay potential complications, thinking, “That won’t happen to me.”

This bias is not just an issue in doctor-patient interactions—it extends to decision-makers responsible for healthcare budgets.

Take HIPAA compliance and information security, for example. Healthcare CFOs and executives often underestimate the risk of data breaches, particularly in smaller organizations or solo practices. Even large healthcare institutions frequently don’t take security seriously until after a breach has occurred.

How Do I Know This?

Experience – As a healthcare CIO for years, I’ve had countless conversations with good people about information security budgets. I’ve had to navigate endless obstacles to secure funding for critical protections.

The Numbers Tell the Story:

• In 2024, healthcare was the most breached industry.
• Government data shows that 94% of healthcare organizations are not HIPAA-compliant. And let’s be clear—HIPAA compliance isn’t just a box to check; it’s below the bare minimum for security.

What Happens When Medical Records Are Leaked?

A data breach in healthcare isn’t just a privacy violation—it’s a direct threat to patient safety, financial security, and even physical well-being.

1. Identity Theft & Fraud – Medical records contain names, addresses, Social Security numbers, insurance details, and even payment information. Once stolen, these records can be sold on the dark web, leading to financial fraud, insurance scams, and stolen identities.
2. Medical Identity Theft – Cybercriminals can use stolen medical information to receive treatment under someone else’s name, leading to incorrect medical records, false diagnoses, and billing nightmares for victims.
3. Blackmail & Extortion – Sensitive health information—such as mental health records, substance abuse treatments, or reproductive health details—can be used to blackmail patients, celebrities, or executives.
4. Discrimination & Reputation Damage – Leaked health records can jeopardize job opportunities, housing applications, or even personal relationships if employers or insurers access private health conditions.

The Threat Goes Beyond Stolen Records—What Happens When They’re Locked Away?

It’s not just about unauthorized access to medical records. Increasingly, cybercriminals encrypt and lock healthcare data, making it completely inaccessible to doctors, nurses, and patients.

This happens through ransomware attacks, where hackers hold medical data hostage, demanding payment before restoring access. The consequences can be catastrophic:

• Delayed or Denied Care – If doctors can’t access patient histories, medication lists, or lab results, they can’t make informed decisions—leading to delayed treatments, incorrect prescriptions, or even fatalities.
• Surgical & Emergency Risks – Imagine a trauma patient arriving at the ER, but the hospital’s systems are locked down. Medication allergies, blood type, and prior conditions might be inaccessible—turning a life-saving intervention into a deadly guessing game.
• Financial Extortion & Operational Shutdowns – Hospitals that refuse to pay ransoms often face weeks of downtime, forcing them to turn patients away, cancel surgeries, and lose millions in revenue.

The Problem is Preventable

One of the easiest ways to mitigate these risks is to conduct regular, mandatory HIPAA Risk Assessments. Shockingly, many organizations fail to complete this basic requirement. That’s the equivalent of a surgeon not washing their hands before surgery.

Beyond that, leaders must meet with their security teams to review findings, assess risks, ask questions, and be prepared to allocate budget for protection.

The True Cost of Ignoring Security

This is where informed consent connects back to HIPAA compliance and healthcare security. Just as patients must understand the risks before undergoing treatment, healthcare executives must fully comprehend the risks of not prioritizing security.

The cost of preventing a breach is minuscule compared to the cost of dealing with one:

• Ransom payments
• Emergency security fixes
• Lost productivity from providers
• The real and immediate danger of disrupted patient care

In the worst cases, attackers don’t just steal medical records—they could gain access to critical medical devices like:

• Medication pumps (altering dosages or shutting them down)
• Heart monitors (manipulating readings or disabling alerts)
• Ventilators and infusion pumps (potentially lethal consequences)

Take Action Now—Before It’s Too Late

The time to act is before disaster strikes, not after. Whether you’re a healthcare executive, IT leader, provider, or policymaker, you have a responsibility to ensure that informed consent extends beyond patient care—it must include protecting the very systems that enable care.

• If you’re in a leadership position: Prioritize HIPAA Risk Assessments and act on their findings.
• If you manage security budgets: Allocate funding to proactively strengthen cybersecurity, not just respond to breaches.
• If you work in healthcare: Advocate for stronger security policies—because a locked or stolen medical record isn’t just data loss; it’s a life-or-death scenario.

The financial, operational, and human costs of inaction are too great. The question isn’t whether an attack will happen—it’s whether you’ll be prepared when it does.

Are you ready to make the tough decisions now, or will you wait until it’s too late?

My company, Magister Business Advisors , advises on HIPAA-compliance, Cybersecurity, and the associated risks and processes. We do not sell software, licenses, or equipment.