Dialogue Volume 11 Issue 2 2015 | Page 40

consent to treatment A framework for consent What circumstances require consent Physicians must obtain consent for all treatment, as defined in the Health Care Consent Act, 1996. maker, regardless of whether or not physicians use supporting documents, including consent forms. Who to obtain consent from In order for consent to be valid, it must be obtained from the patient if they are capable with respect to the treatment or from the substitute decision-maker if the patient is incapable with respect to the treatment. How consent can be given Consent to treatment may be express (explicit) or implied (implicit). What elements are required for consent In order for consent to be valid, it must be related to the treatment, informed, given voluntarily, and not obtained through misrepresentation or fraud. If any of these requirements are not met, the consent may not be valid. When obtaining consent the College requires physicians to engage in a dialogue with the patient or substitute decision- cians must be satisfied that the information is understood” and sets out the expectation that physicians “take reasonable steps to facilitate the comprehension of the information provided.” If physicians are unsure of whether the consent obtained is valid, treatment must not be provided until A legible, the physician is assured that understandable and valid consent has been obtained, states the policy. contemporaneous The policy also states that note in the patient’s a legible, understandable and record is the best contemporaneous note in the patient’s record regardevidence that the ing consent to treatment is dialogue took place the best evidence a physician has to demonstrate that the dialogue took place and informed consent was given. 40 Dialogue Issue 2, 2015 When and what to document The College requires physicians to document information regarding consent to treatment in certain circumstances, and recommends that this be done in all other circumstances. When emergency treatment can be provided without consent In emergencies, treatment can only be provided without consent when certain requirements are met. As such, the College requires physicians to document regarding consent to treatment in certain circumstances, but r X