The clinical purpose of consent is to enlist the patient’s faith and confidence in the efficacy of the treatment. This is a major factor in contributing to the success of the treatment. The legal purpose is to provide those treating patients with a defence to a criminal charge of assault or battery, or a civil claim for damages for trespass to the person. However, it does not provide them with a defence to a claim that they have negligently advised or counseled a particular treatment or carried it out in a negligent manner. Thus the notion of consent to treatment is essentially a very practical issue, and is advantageous to both doctors and patients.
The patient, if is competent and is an adult, has the right to decide on the procedures done to his/her own body. It is a basic human right and thus the patient can either withhold or agree to treatment even if the treatment is a life-saving one. This is termed as authoritative autonomy. And the patient practices it by consenting.
“Consent is the voluntary and continuing permission of the patient to receive a particular treatment based on an adequate knowledge of the purpose, nature and likely risks of the treatment including the likelihood of its success and any alternatives to it. Permission given under any unfair or undue pressure is not consent.” (Department of Health 1993).
The key components of informed consent is basically that the patient has to be given adequate information about the general procedure. In some procedures, there is the uncertainty in the procedure meaning that the surgeon is unable to adequately predict the outcome of the surgery and what may need to be done during the surgery until the surgery is under way. Thus in such cases, the surgeon will not be liable for any legal action. The patient has the right to know about any risks or benefits, even if it is rare and especially if it is a serious side effect. And the information must be presented to the patient in such a way that the patient is able to understand it. Medical terminology may tend to be rather difficult at times and that needs to be simplified so that the patient who is a layman is able to understand the doctor. There has been concerns that medical practitioners generally tend to not give adequate information about the risks involved. And in some cases, even if the risk is rare, it may still occur. Such as the case of the Australian doctor who did not inform the patient about the 1 in 14000 risk of having eye damages in the surgical procedure. The patient also should not be given too much information or information that is skewed in the sense that it coerces the decision of the patient by unnecessarily exaggerating the risks or benefits.
Secondly, the patient must have the ability to comprehend the information. In legal terms, it is termed capacity. There are a number of acts that sets out rules and guidelines to figure out which patients are considered competent and which patients are not. The Mental capacity act of 2005, which sets out guidelines for the mentally disabled above the age of 16, the children act of 1969 for minors who are under 16 and the family act that refers to those between 16 and 17 who are not legally adults but is considered competent to give consent in the medical society.
The consent has to be obtained. It can be verbal or written but it is better and safer for the doctor to have it done written since the doctor will now have evidence that can be used in court to prove that the consent was taken. There are also certain regulations for circumstances when the patient is an adult and used to be competent but is currently unconscious or in too much pain from the disease. In such cases, the family may be asked for information about any advanced medical derivatives or any proxy appointed to make the decision for the patient.