Consent

Legal and Ethical Importance of Informed Consent

1. Patient Autonomy: Respecting the patient’s right to make decisions about their own body and treatment.
2. Legal Requirement: UK law requires healthcare professionals to obtain valid consent before providing treatment or care.
3. Trust and Communication: Building a trusting relationship through transparent communication.
4. Professional Standards: Adhering to guidelines set by professional bodies such as the General Medical Council (GMC) and the Nursing and Midwifery Council (NMC).

Key Principles of Informed Consent

1. Voluntariness: Consent must be given freely without coercion or undue influence.
2. Capacity: The patient must have the mental capacity to understand the information and make a decision.
3. Information: Sufficient information must be provided to the patient, including the nature, risks, benefits, and alternatives of the proposed treatment.
4. Comprehension: The patient must understand the information provided.
5. Decision: The patient must give explicit permission for the proposed treatment.

Types of Consent

1. Implied Consent: Non-verbal or implied through the patient’s actions, suitable for minor or routine procedures.
2. Verbal Consent: Given verbally, appropriate for less invasive procedures.
3. Written Consent: Documented consent, required for more invasive or high-risk procedures.

Communicating About Consent

1. Clear and Simple Language: Avoid medical jargon and explain in a way that is easy to understand.
2. Check Understanding: Ask the patient to repeat the information in their own words to confirm comprehension.
3. Discuss Alternatives: Explain all available options, including no treatment.
4. Answer Questions: Encourage and answer any questions the patient may have.
5. Use Visual Aids: Diagrams or models can help explain complex procedures.

Process for Obtaining Consent

1. Assess Capacity:
   • Legal Framework: Follow the Mental Capacity Act 2005 to assess if a patient can make their own decisions.
   • Capacity Assessment: Determine if the patient can understand, retain, use, and weigh information, and communicate their decision.
2. Provide Information:
   • Nature of Treatment: Explain what the treatment involves.
   • Risks and Benefits: Detail the potential risks and benefits.
   • Alternatives: Discuss alternative treatments and their risks and benefits.
   • Consequences of Refusal: Explain what might happen if the treatment is refused.
3. Document Consent:
   • Record Keeping: Document the consent process, including information provided and the patient’s decision.
   • Written Consent Forms: Use for invasive or high-risk procedures, signed by both patient and healthcare professional.
4. Ongoing Process: Consent is not a one-time event. Continue to inform and obtain consent as treatment progresses or changes.

Special Considerations

1. Children and Young People:
   • Parental Consent: Generally required for children under 16, but consider the child’s ability to understand (Gillick competence).
   • Young People (16-17): Can consent for themselves, but parents may still need to be involved in certain situations.
2. Patients with Impaired Capacity:
   • Best Interests: Make decisions in the patient’s best interests if they lack capacity, involving family or legal representatives as appropriate.
   • Advance Decisions: Respect any advance decisions or directives made by the patient when they had capacity.
3. Emergency Situations:
   • Immediate Action: If immediate treatment is necessary to save a life or prevent serious harm, proceed without consent but explain as soon as possible after the event.