(according to the current law in the UK)

 The legal and ethical principle where a patient agrees to the treatment,

a physical investigation or personal care.

must be valid:

1. 1. given voluntarily

   2. given by a competent person

   3. ability to understand and remember the given information

   4. ability to weigh up risks and benefits of the procedure

   5. consequences of not having the procedure)

   6. appropriate information is provided (nature + purpose of the procedure, pan relief, complications/risks, alternative treatment options)
      
      
      

• • explanation of common risks (e.g. nausea) and also severe complications even if they are rare (e.g. nerve injury)

  • patients individual experience and background are taken into account (e.g. values, social background, culture, religion, beliefs, intellect)

  • documentation of the agreed anaesthetic and post-operative plan including a list of risks explained (separate anaesthetic consent forms are currently not necessary)

  • separate anaesthetic consent forms are currently not necessary (some departments make use of them)
    
    

Special situations

1. Refusal of treatment

• a well-informed patient with capacity can voluntarily refuse treatment (even when this results in death)
• this has to be accepted by the health care professional

2. Advance directives

= refusal of treatment in advance in case of future incapacity

= written "living will" by a competent person

- are legally binding

3.a Young adults (>16 years)

• • can give consent without separate consent from a parent or guardian

3.b Children and young adults (<16 years)

• • can be competent to give consent (if able to understand the information provided and to outweigh risks & benefits)
  • children and young adults who refuse treatment can be overridden by a parent or court
  • the treatment has to be in the childs best interest
  • parents can consent for children without capacity

4. Emergency

• • verbal consent by telephone is adequate
  • consent is not necessary in life-threatening situations
  • if a child or parent refuse treatment a court order can be obtained (but that should not delay emergency treatment)

5. Unconscious patients

• • essential treatment is possible without consent
  • it is good medical practice to inform the next of kin
  • the next of kin can not give or refuse treatment

6. Restricted consent

• • certain aspects of treatment may be refused (e.g. blood transfusion in Jehova's Whitnesses)
  • must be discussed with patients in detail so that the patient understands the consequences of refusal
  • must be respected at all times
  • the patient can change this decision at any time

7. Research / Teaching

• • the same legal principles apply as for giving consent