Medical Consent
Medical consent is where the patient gives permission before any medical treatment, test or examination. It is important that informed consent is given where the patient is debriefed on the treatment and knows exactly what the procedure and effects will be. Gaining informed consent from patients is crucial in the field of medicine and ties in closely to the pillar of justice and a patient’s autonomy.
Consent can be given in two ways:
Verbally – Where the patient tells the doctor directly that they are happy for them to proceed with the treatment/ test.
Written – The patient is given a consent form for their treatment and they sign it.
Sometimes patients may not always be medically able to give consent for a treatment/test so, the doctor can consult with family and friends of the patient or make the decision to go forward with the treatment, but only if doing so is in the patient’s best interest. In order for doctors to decide when it is appropriate to do so, they assess a patient’s capacity to exercise their right to consent. Doctors will assess a patient’s body language, facial expressions and mental ability to make a judgement regarding their capacity. All patients are assumed to have capacity until proven otherwise, in accordance with the NHS’ values to provide unbiased care. Some scenarios where patients could have limited capacity are a patient with dementia or severe learning disabilities.
In order for a patient’s consent to be valid the following conditions have to be met:
The patient must be above the age of 16 (depending on whether they are Gillick competent/ meet the Fraser guidelines*)
The patient must be able to give consent without any form of pressure from other people
The patient must be mentally able to make the decision
*Gillick competence refers to the wider context of assessing a child’s ability to make informed decisions and understand the implications of said decisions. The Fraser Guidelines refer more specifically to advice and treatment relating to contraception and the sexual health of minors. Both terms originate from a 1980s legal case on whether a doctor should be able to give advice and treatment regarding sexual health to a young person without parental consent.
There are some instances where consent from the patient does not have to be given beforehand:
In life-threatening and emergency situations where if the doctor does not operate immediately the patient may lose their life (even if this patient is a minor, the parents do not have the right to deny life-saving treatment on their behalf)
Where the patient may be a risk to others or themselves due to severe mental health conditions (to forcibly keep a patient in hospital)
Where the patient has a severe mental health condition
When someone is extremely ill and living in unsanitary conditions
In all of these cases, doctors must have a clear medical reason why waiting to obtain consent would compromise patient care and, in cases of unconsciousness at time of treatment, the full treatment should be explained to the patient afterwards.
In ethical scenario interview questions, always consider the patient’s right to give and withdraw consent which not only applies to treatment but medical research studies. If a patient is able, it is paramount that healthcare professionals gain their consent to avoid compromising care and the legality of treatments.
