Informed Patient Consent- Adults
Informed Consent is giving permission or agreement for an examination, intervention or treatment following a conversation in which the patient has received enough information to enable him/her to understand the nature and potential risks and benefits of the proposed examination, intervention or treatment.
In order to be valid consent must be:
Voluntary- not influenced by Healthcare Professionals. The person must understand that they have a choice.
Informed- the person must be given all the information they require regarding the examination, intervention or treatment. Information must include risks as well as benefits, any alternatives to the proposed examination, intervention or treatment and possible complications.
The person must have the Capacity to consent- the ability to understand the nature and consequences of a decision at the time the decision is to be made. The person should ask questions if they don’t understand any of the information given to them. A person is always presumed to have the capacity to consent unless the opposite has been demonstrated.
A person lacks capacity if their mind is impaired or disturbed in some way, and this means the person is unable to make a decision at that time. A person’s capacity is assessed each time a decision needs to be made, as a person’s capacity can change. Capacity is assessed by the healthcare professional who is asking for the person’s consent.
Consent can be:
“Can I examine your tummy?” “Yes.”
“Can I take your blood pressure?” Patient holds arm up.
Signing a consent form for an operation.
In emergency situations where the treatment is immediately necessary to save the life or preserve the health of the person the necessary treatment may be administered without expressed consent.
Consent- Incapacitated Adults
The possibility of incapacity and the need to formally assess capacity should only be considered if, having been given all appropriate help and support, a person:
- is unable to communicate clear and consistent choice or
- is obviously unable to understand and use the information and choices provided.
Who can give consent for an incapacitated adult
Currently there is no legislation to govern how a decision about treatment and care should be made for those who lack capacity. However, Irish case law, national and international guidelines suggest that the healthcare professional should determine what is in the best interests of the person with reference to their values, beliefs and preferences if known.
Role of the family
No other person such as a family member, friends or carer can give or refuse consent on behalf of an incapacitated adult unless they have specific legal authority to do so.
Their role is to provide greater insight into the person’s previously expressed views and preferences and to outline what the person wanted to do.
16 and 17 Year olds
16 and 17 year olds are still defined as minors under current legislation unless they are or have been married. Minors who have reached 16 years of age can give consent to any surgical, medical or dental treatment as if they had reached adult age. It is not necessary to obtain any consent from his or her parent or guardian; however it is good practice to involve the parent or guardian if the 16 or 17 year old wishes.
For children under the age of 16 years, a parent or legal guardian can consent to the treatment of the child.
There are no provisions in Ireland for children to consent or refuse medical treatment. Unlike other countries, there is no ‘mature minor’ recognition within the State. However, it is good practice to involve the child in the decision-making process and listen to their wishes and concerns.