The dictionary definition of consent is “To give permission for something to happen or agreement to do something”.
The principle of consent is an important part of medical ethics and international human rights law. As such, consent should be obtained willingly – that is, without coercion, inducement, undue influence or pressure.
In healthcare it is about your agreement – giving your permission – to receive any type of medical care – including physical examination, test or treatment.
Before anything happens – you should receive a clear explanation of the reasons for and potential consequences of the examination, test or treatment. Also time to consider your decision and the opportunity to ask any questions you may have and / or to express any concerns.
You do not have to give your permission – but as consent is required before anything takes places – if you do not agree to it, it won’t happen.
And remember that even if you have given consent, but change your mind at any point before the examination, test or treatment starts, you are fully entitled to withdraw your previous consent – and it will stop or not go ahead.
There are different types of consent
- Non-verbal – for example. holding your arm out to allow for a blood test to occur
- Verbal – for example, saying you are happy to go ahead with a scan
- Written – for example, signing a consent form for surgery.
However, for each of these it is vitally important that the healthcare professional responsible for undertaking the examination, test or treatment, ensures that you understand what is going to happen – as well as any potential risks or side effects. For example – bleeding from or bruising at the needle site after having blood taken.
Consent must be voluntary and informed, and you must have the capacity to make the decision.
The meaning of these terms are:
- Voluntary – the decision to give or withhold consent is yours – and yours alone, and must not be coerced or unduly influenced by pressure from medical staff, friends or family
- Informed – you must be given all of the information about what the examination, test or treatment involves, including the benefits and risks, whether there are reasonable alternatives, and what will happen if it does not go ahead. Informed consent is also about ensuring that you understand the information you have been given, have had time to think about the information and been given the opportunity to ask any questions you may have – and received the answers you need
- Capacity – you must be capable of giving consent, which means that you need to be able to understand the information you have been given and have the ability to use it to make an informed decision.
If you have the capacity to make a voluntary and informed decision to give or withhold your consent – your decision must be respected.
Consent by others
If you do not have the capacity to make a decision about an examination, test or treatment and you have not appointed a lasting power of attorney (LPA) the healthcare professionals responsible for your care may go ahead – if they believe it’s in your best interests.
However, the healthcare professionals involved must take reasonable steps to discuss the situation with your next of kin, friends or relatives before making these decisions.
Consent from children and young people
If they’re able to, consent is usually given by the child themselves. However, up to the age of 16, the person with parental responsibility may need to give consent for a child to have treatment.
Making your wishes known
A person may be being kept alive with supportive treatments, such as lung ventilation, if an “Advance Decision” (Living Will), which outlines the care they would not like or would refuse to receive, hasn’t been made or recorded in their medical records.
In these cases, a decision about continuing or stopping treatment needs to be made based on what that person’s best interests are believed to be. To help reach a decision, healthcare professionals should discuss the issue with the relatives and friends of the person receiving the treatment.
Making an Advance Decision (Living Will) – or an Advance Statement or a Lasting Powers of Attorney for Health and Welfare – can be completed (and updated) at any time and gives you the opportunity to make your wishes clear, should you, in the future, become unable to confirm those wishes yourself. There are subtle differences between the three.
There are differences between an Advance Decision, an Advance Statement and a Lasting Powers of Attorney for Health and Welfare.
Exceptions to consent
There are a few exceptions when an examination, test or treatment may be able to go ahead without your consent, even if you’re capable of giving your permission.
If you’ve made an Advance Decision, Advance Statement or Lasting Power of Attorney, this should be noted in your medical records – and your next of kin/designated representative should be aware of it.