Patient Consent

Elizabeth Charnock, Denise Owens

• Publisher: Routledge
• Year: 2017
• Print ISBN:
  9781138357945
• eBook ISBN:
  9781351223928
• Topic: Medicine
• Subtopic: Ethics in Medicine

Ideal for quick reference, this pocket-sized (120x80mm), spiral-bound book in the popular Nursing & Health Survival Guide series puts all the crucial information about patient consent at your fingertips.

There is an obligation for practitioners to obtain valid consent from their patients before examination, routine personal care or therapeutic treatment. However, the law relating to consent is complex. Situations may arise where a patient requires urgent treatment, yet is either unwilling or unable to give their consent, or there are concerns over the form and context of the consent.

All you need to know on:

• the underlying principles of consent;
• consent and the adult patient;
• consent and the adult who lacks capacity;
• children and consent;
• young people and consent.

Underlying principles of patient consent

■ THE IMPORTANCE OF PATIENT CONSENT

In the light of the inquiry into the care of children at the Bristol Royal Infirmary, the Kennedy Report (Bristol Royal Infirmary Inquiry, 2001) stressed the importance of gaining patient consent prior to any treatments or clinical procedures that involve touching the patient and not just those, such as surgical interventions, considered to pose a high risk to patient safety. The recommendations emphasise that gaining consent is much more than a ‘one-off’ task of obtaining a signature on a form; it is instead a process of informing and communicating effectively with the patient and, if appropriate, their family.

• In the absence of a real or valid consent to treatment, or alternative legal justification for the treatment, a claim of trespass to the person could result.

• In suing for trespass to the person, the claim is one of battery (actually touching the patient without their consent or alternative legal justification) and/or assault (where the patient was in fear of being touched against their wishes).

(Dimond, 2011)

■ WHO SHOULD GAIN PATIENT CONSENT?

• The practitioner who is going to carry out the investigation or treatment does not necessarily need to be the one who obtains the patient’s consent – this can be delegated to another appropriately trained and competent practitioner.

• It is, however, the responsibility of the practitioner carrying out the investigation or treatment to ensure that a valid patient consent has been obtained.

• The practitioner who gains the consent needs to be knowledgeable about the proposed treatment or investigation to give accurate information to the patient and respond to all the patient’s questions and concerns.

• All practitioners need to be aware of their limitations and are responsible for seeking help from more experienced and knowledgeable colleagues if they are unsure in any part of the process of gaining consent.

(Department of Health, 2009)

■ VERBAL CONSENT

Healthcare practitioners owe a duty of care to the patient to ensure that consent is gained prior to any treatment or clinical procedure that involves touching the patient. Not all treatments and procedures will, however, require written consent; in certain circumstances, verbal or implied forms of consent will suffice.

Verbal consent to treatment is agreed through discussion and negotiation with the patient and is a feature of general everyday care activity and treatments considered to pose less risk to patients (Dimond, 2011).

• Discussing care and proposed treatments with patients should not be viewed by practitioners as an inconvenience but instead as an essential component of everyday practice and a prerequisite to building a therapeutic partnership built on trust.

■ IMPLIED CONSENT

In implied consent, the patient demonstrates clearly via non-verbal language that they consent to the treatment being offered; for example, by lifting their top to allow for and facilitate the auscultation of their chest or by lifting their shirt sleeve, revealing and positioning their arm to facilitate venepuncture, or, in the case of a parent, assisting in positioning and holding still their young child’s head to facilitate an aural examination.

• The problem with implied consent is that the treatment usually occurs with little or no negotiation or information being relayed to the patient about the treatment.

• An assumption is made by the practitioner that the patient understands the treatment offered but the risk is that they may not. If a patient does not understand the treatment or why they are having the treatment, consent is invalid.

• To avoid the practitioner incorrectly assuming that the patient understands and agrees to the proposed treatment, practitioners are advised to inform the patient about what they intend to do and seek their verbal agreement prior to performing the treatment.

(Dimond, 2011)

■ WRITTEN CONSENT

Written consent involves the patient signing a consent form to confirm that they agree to the proposed treatment. Although written patient consent is not generally a legal requirement (other than under specific terms of the Mental Health Act 1983 and the Human Fertilisation and Embryology Act 2008), it is considered good practice to obtain written consent prior to the patient undergoing surgery (Department of Health, 2009). The Department of Health (2009), as part of their review of the Reference Guide to Consent for Examination or Treatment, offer advice regarding the content of a range of consent forms to reflect the requirements of the Mental Capacity Act 2005 and influential case law regarding the requirements of a valid consent. The consent form used should reflect the specific needs of the patient with regard to consent; for example:

• Adults and young people over 16 years who have the capacity to consent for treatment.

• Consent from a person with parental responsibility on behalf of a child.

• Consent for procedures that do not impair consciousness.

• In cases where the adult lacks the capacity to consent to treatment, the decision, based on the best interests of the patient, should be justified in writing (Department of Health, 2009).

Obtaining written patient consent involves much more than completing the task of gaining the patient’s signature on a form. Gaining patient consent is a process of informing and communicating with the patient to check their understanding of the proposed treatment and their willingness to consent.

• Written consent should, if possible and appropriate, be gained well in advance of the pr...

Table of contents

• Cover
• Title Page
• Copyright Page
• Table of Contents
• Patient Consent: A Significant Contribution to Respectful Patient Care
• Underlying Principles of Patient Consent
• Consent and the Adult Patient
• Consent and the Adult Who Lacks Capacity
• Children and Consent
• Young People and Consent
• References
• Useful Websites