Consent from a patient is needed regardless of the procedure – whether it's a physical examination, test, or type of medical treatment. This must be given following an explanation by a clinician. The principle of consent is an important part of medical ethics and International Human Rights Law.
For consent to be valid, it must be voluntary and informed, and the person consenting must have the capacity to make the decision. If a patient doesn't have the capacity to make a decision about their treatment, the healthcare professionals treating them must take reasonable steps to seek advice from the patient’s friends or relatives before making any decisions.
Patient Consent can be given either:
Verbally – for example, by saying they're happy to have an X-ray;
In Writing – for example, by signing a consent form for surgery.
Someone could also give non-verbal consent, as long as they understand the treatment or examination about to take place – for example, by holding out an arm for a blood test.
Consent should be given to the healthcare professional directly responsible for the person's current treatment.
If someone is going to have a major medical procedure, such as an operation, their consent should ideally be secured well in advance, so they have plenty of time to obtain information about the procedure and ask questions. The person is entitled to change their mind and withdraw their previous consent at any point before the procedure.
Patients must be kept informed and be able to make decisions at all stages of their treatment, not just in the initial stage. Clear arrangements must be in place to review treatment decisions and, if necessary, to make new ones.
If they're able to, consent from children and young people is usually given by patients themselves. However, someone with parental responsibility may need to give consent for a child up to the age of 16 to have treatment.
Arguably the most controversial aspect of obtaining consent relates to the level of information that should be provided to the patient, in order to obtain effective consent.
Consent to treatment requires two types of information:
Information regarding the broad nature of the procedure;
Information regarding the risks involved with a procedure.
Before accepting a patient’s consent, clinicians must consider whether they have given the information required and how well this has been understood. This is more important than how the patients consent is expressed or recorded.
Clinicians must use the patient’s medical records or a consent form to record the key elements of their discussion with the patient. This should include the information they discussed, any specific requests by the patient, any written, visual or audio information given to the patient, and details of any decisions that were made.
All clinicians have a duty of care to understand and apply the legal and ethical principles which underpin consent to treatment. These principles are explained in the BAD’s Guide to Validating Consent for Dermatology Examinations or Treatments 2017. Additional GMC guidance for doctors sets out the consent principles on which good clinical decisions should be based, including cosmetic interventions.