Consent to treatment is the principle that a person must give their permission before they receive any type of medical treatment.
Consent is required from a patient regardless of the treatment, from blood test to organ donation.
The principle of consent is an important part of medical ethics and the international human rights law.
Defining consent
For consent to be valid, it must be voluntary and informed, and the person consenting must have the capacity to make the decision. These terms are explained below.
- Voluntary: the decision to consent or not consent to treatment must be made alone, and must not be due to pressure by medical staff, friends or family.
- Informed: the person must be given full information about what the treatment involves, including the benefits and risk, whether there are reasonable alternative treatments, and what will happen if treatment does not go ahead. Healthcare professional should not withhold information just because it may upset or unnerve the person (see below)
- Capacity: the person must be capable of giving consent, which means they understand the information given to them and they can use it to make an informed decision.
If the person has enough capacity and makes a voluntary and informed decision to refuse a particular treatment, their decision must be respected. This is still true even if their decision would result in their death, or the death of their unborn child.
How to give consent
Consent should be given to the healthcare professional directly responsible for the person’s current treatment, such as the nurse arranging a blood test, the GP prescribing new medication or the surgeon planning an operation.
It can be given:
- verbally
- non-verbally, for example, raising a hand to indicate they are happy for a nurse to take a blood sample.
- In writing, by signing a consent form.
If someone is going to have major medical intervention, such as an operation, their consent should be obtained well in advance so they have plenty of time to study any information about the procedure and ask questions.
Withholding information
To consent to a treatment or procedure, the person needs to be fully informed about the treatment and understand why it is considered necessary.
Healthcare professionals should not withhold information just because it may upset or unnerve the person. Even if the person specifically requests not to be told about the extent or likely outcome of their condition, the healthcare professional has a moral and legal responsibility to provide them with at least:
- A basic overview of the condition
- the likely outcome of their condition
- their treatment options.
Involving the court of protection
There are some circumstances where a decision should always be referred to the Court of Protection if the person cannot give their consent. Situations that should always be referred to the courts include:
- sterilization for contraceptive purposes
- donation of regenerative tissue, such as bone marrow
- withdrawal of nutrition and hydration from a person who is in a persistent vegetative state
- where there is serious concern about the person’s capacity or best interests.
When consent is not necessary
There are a few exceptions when treatment can go ahead without consent.
One main exception is if a person does not have the mental capacity (the ability to understand and use information) to make a decision about their treatment. In this case, the health care professionals can go ahead and give treatment if they believe it is in the person’s best interests.
To read about consent options please see the www.nhs.uk