conSent
essential guide
to consent
the gMc’s guidance on consent – Consent: patients
and doctors making decisions together – is the most
important document for gps. Here is a breakdown
of the contents
Why obtain consent? Who should take to be adversely affected, a
it is not only good practice consent? parent’s refusal to consent
to be familiar with consent if you are providing treatment, in these circumstances can
guidance, but the gMc it is your responsibility to obtain be overruled by the courts.
will judge your practice consent. if you are asked to
against it, which could have get consent for a particular How should consent
a bearing on your future treatment you should only be given?
career. even the briefest do so if you are competent. according to the gMc,
physical examination cannot you must give patients the
be performed without Who can give consent? information they need about:
consent. no-one has the patients under the age of 1. the diagnosis
right to touch anyone else 16 may or may not have and prognosis
without lawful excuse and the capacity to consent to 2. any uncertainties,
if doctors do so it may well treatment. the test of capacity including options for
undermine patients’ trust. in children is still whether or further investigations
if consent is not obtained, not they are gillick competent. 3. options for treating
a clinical negligence claim, if they are able to understand and managing the
a complaint or even civil or information about their condition, including the
criminal proceedings for condition and the implications option not to treat
assault could follow. respect of either, proceeding with 4. the purpose of proposed
for patients’ autonomy is the treatment, or doing treatments and what
expressed in consent law; to nothing, they should be they will involve
impose care or treatment on considered competent to 5. the potentials risks,
people without respecting provide consent. the capacity burdens and likelihood of
their wishes and right to to consent depends more success of each option
self-determination is not on a young person’s ability 6. Whether a treatment
only unethical, but illegal. to understand and weigh is experimental
up options, than on age. 7. Who is responsible
What is consent? When assessing a young for the treatment and
consent must be freely person’s capacity to consent, the seniority of those
given by a competent you should bear in mind: involved, to what extent
patient voluntarily making an ■ at 16 a young person can students will be involved
informed decision. consent be presumed to have the 8. their right to refuse to
is about more than a single capacity to consent. take part in research
decision; rather it is a ■ a young person under 16 or teaching
process to inform the patient may have the capacity to 9. their right to seek a
of the nature and purpose consent, depending on second opinion
of their condition and its their maturity and ability to 10. any bills they will
treatment. consent must fulfil understand what is involved. have to pay
three conditions to be legally if the child or young person 11. any conflicts of interest
valid. the patient must be: withholds consent or is that you may have
■ capable of giving consent. lacking capacity, someone 12. information on any
■ sufficiently informed to with parental responsibility better treatments than
make a considered decision can consent on their behalf. the ones offered by you
■ giving consent voluntarily. in cases where a child is likely or your organisation.
8 sessional gp | voluMe 1 | 2009 www.mps.org.uk
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