Figure 1: Steps in the consent process
Obtaining a patient’s consent to treatment is not just a matter of asking for a signature on a consent form; it is a communication process.
Step 1: Threshold Elements
Assess the patient’s decisional capacity. Check that the patient is not under undue duress (ie, is able to make a voluntary decision) .
Step 2: Informational Elements (see Box 5)
Describe the proposed intervention. Discuss risks, benefits and consequences of the proposed intervention/including costs/no charge, and check that the patient understands the information and can make and communicate a rational decision based on that information.
Step 3: Consent Elements
The patient makes a decision. The patient communicates his/her decision and, if appropriate, signs a consent form (authorisation).
Step 4: Confirmation Elements
The patient is reminded that consent can be withdrawn at any time. If there has been a delay between authorisation and the procedure, the patient’s willingness to proceed is confirmed.