Every day, patients consent to undergo medical treatments such as investigative procedures, surgeries, taking medications etc. Patients make these decisions based upon information received from the healthcare professional and their capacity to comprehend the risks and benefits of receiving or not receiving the treatment. According to the NHS capacity to consent implies that the consent is voluntary, informed and the person has to capacity to make the decision. Capacity to consent brings together the ethical, legal and professional responsibilities of healthcare practitioners with regards to consent to treatment and decision making. Lemont et al (2013) highlight that it is the responsibility of the healthcare professional to be familiar with issues regarding mental health capacity, consent and the legal documents that guide decision making.
- Define voluntary, informed, capacity and consent.
- Outline different types of consent.
- What ethical principles are observed when obtaining informed consent?
- How is capacity of a patient determined?
- When would you consider incapacity – in what situations?
- Outline situations where it is not necessary to obtain consent.
- Reflect on a clinical experience you encountered in relation to a patient who did not have capacity to consent to a procedure/ test/ treatment. Discuss your feelings and thoughts in relation to this patient situation.
She reminds us of the 3 exceptions to this rule which are
A high level threat to the patient
A high level of threat to the public
When there is a legal obligation to do so
Remember that the bar is set high and that the general rule is to gain the consent of the patient before 3rd party disclosure.
Once we have assessed capacity to consent and gained the necessary consent from the patient, we then have to document this. Dr Doran from UCC highlights the issues regarding this.
Gaining consent from those patients who are minors raises some other problems. Dr Doran UCC discusses some of these briefly and also talks about the Fraser (Gillick) competencies that can be considered in the UK but not in Ireland.
Directorate, Q.P.S. (2013 May) National Consent policy. Vol. Quality and Practice Directorate.
NHS Choices [accessed 30.9.16] Consent and treatment. http://www.nhs.uk/Conditions/Consent-to-treatment/Pages/Introduction.aspx
Lamont, S., Jeon, Y.-H. & Chiarella, M. (2013) Health-care professionals’ knowledge, attitudes and behaviours relating to patient capacity to consent to treatment: An integrative review. Nursing Ethics, 20(6), 684-707.