Medical Consent

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Medical Consent

• Module 1

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This session will

• explain why consent is important
• outline the basic processes and considerations
  involved
• develop your ability to judge how to handle
  consent issues
• set out the legal and regulatory framework.

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Why consent is necessary

• Every adult has an inviolable right to determine
  what is done to his or her body. Lord Donaldson
• Legal obligations.
• Good practice.

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Some examples of procedures that need consent

• Surgical procedures.
• Medical procedures.
• Interventional and radiological procedures.
• Radiotherapy and chemotherapy.
• Intimate examinations.
• Blood tests.

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The person obtaining consent must

• be suitably trained
• have sufficient knowledge of the proposed
  investigation or procedure, and understand the
  risks involved
• practise in line with their professional bodys
  standards.

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GMC guidance 1

• Give patients the information they ask for or
  need about their condition, its treatment and
  prognosis.
• Provide it in a way they can understand.
• Be satisfied the patient has understood what is
  proposed and consents to it.
• from the GMCs Good Medical Practice

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GMC guidance 2

• Respect patients rights to be fully involved in
  decisionsabout their care.
• Respect their right to decline treatment or take
  partin teaching or research.
• Respect their right to a second opinion.
• from the GMCs Good Medical Practice

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Patients need information on

• the nature of the intervention
• its purpose
• the risks and side effects
• the benefits
• alternatives.

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Deciding how much information

• Think about the
• nature of the condition
• complexity of the procedure
• frequency of adverse effects, their seriousness
  and permanence
• risk-benefit ratio of the treatment
• urgency of the treatment
• patients lifestyle, wishes or emotional state.

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Information issues

• Emergencies.
• Anticipatory consent.
• Conditional consent.
• Withholding information.
• Questions.
• Patient information leaflets.
• Recording whats happened.

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How patients may give consent

• Voluntarily.
• Expressly.
• Express verbal.
• Express written.
• Implied consent.

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Basic assumption on competence

• Every adult has the capacity to decide whether
  to consent to, or refuse, proposed medical
  intervention, unless it is shown that they cannot
  understand information presented in a clear way.
• GMC. Seeking patients consent the ethical
  considerations

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A competent patient can

• comprehend information presented to them clearly
• believe it
• retain it long enough to consider it and
• make a decision.

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Filling in the consent form

• No abbreviations.
• Legible.
• Unambiguous.
• Signed and understood by the patient.
• Signed and understood by you.
• Dated.
• Part of the medical records.

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When to obtain formal consent

• Principles before pre-med, time to think, when
  they understand.
• Changes in patient condition, to planned
  procedure,if new information.
• Time lapses.
• Withdrawing consent.

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Good practice adviceand standards

• Registration bodies.
• Professional bodies.
• Department of Health.
• Your Trust.
• The CNST.

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CNST standard 7 assessment

• Patient information shows the risks/benefits of
  common elective treatments.
• Consent forms comply with NHSE guidelines.
• The Trusts consent policy for elective
  procedures states that a person capable of
  performing that procedure obtains consent.
• There is a clear way for patients to get more
  information.

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