Consent to Treatment Policy
At our Practice we believe that your involvement in decisions about your healthcare is essential. Consent to treatment is the principle that a person must give permission before they receive any type of medical treatment, test, or examination. This is generally requested after a clinician has provided a clear explanation of the required treatment, test, or procedure.
Consent from a patient is needed regardless of the procedure, whether it is a physical examination, organ donation, or any other medical intervention. The principle of consent is a vital part of medical ethics and international human rights laws.
Defining Consent
For consent to be valid, it must be voluntary and informed, and the person consenting must have the capacity to make the decision. These terms are defined as follows:
- Voluntary: The decision to either consent or not to consent to treatment must be made by the person themselves. It must not be influenced by pressure from medical staff, friends, or family.
- Informed: The person must be given all necessary information regarding what the treatment involves, including the benefits and risks, whether there are reasonable alternative treatments, and what will happen if the treatment does not go ahead.
- Capacity: The person must be capable of giving consent, meaning they understand the information given to them and can use it to make an informed decision.
If an adult has the capacity to make a voluntary and informed decision to consent to or refuse a particular treatment, their decision must be respected. This remains the case even if refusing treatment would result in their death or the death of an unborn child.
If a person does not have the capacity to make a decision about their treatment, the healthcare professionals treating them can proceed if they believe it is in the person’s best interests. However, clinicians must take reasonable steps to seek advice from the patient’s friends or relatives before making these decisions.
How Consent is Given
Consent can be provided in various ways depending on the situation:
- Verbally: For example, by saying you are happy to have an X-ray.
- In writing: For example, by signing a consent form for surgery.
- Non-verbally: For example, holding out an arm for a blood test, provided you understand the treatment or examination about to take place.
Consent should be given directly to the healthcare professional responsible for your current treatment, such as a nurse arranging a blood test, a GP prescribing new medication, or a surgeon planning an operation.
If you are undergoing a major medical procedure, your consent should ideally be secured well in advance. This ensures you have time to obtain information and ask questions. If you change your mind at any point before the procedure, you are entitled to withdraw your previous consent.
Consent from Children and Young People
In Scotland, the law often allows young people under the age of 16 to provide their own consent if they are deemed to have the capacity to understand the nature and consequences of the treatment. This is often referred to as being “Gillick competent.” If a child is not able to provide consent, someone with parental responsibility may need to give consent on their behalf. You can find more detailed guidance on Rights and Enquiries via NHS Inform.
When Consent is Not Needed
There are a few exceptions where treatment may proceed without consent, even if the person is capable of giving permission. These include:
- Emergency treatment: If a person requires emergency treatment to save their life but is incapacitated (for example, unconscious). The reasons why treatment was necessary should be fully explained once they have recovered.
- Additional procedures during surgery: If a patient immediately requires an additional emergency procedure during an operation and there is a clear medical reason why it would be unsafe to wait.
- Mental health conditions: Under the Mental Health (Care and Treatment) (Scotland) Act 2003, a person with a severe mental health condition who lacks the capacity to consent may be treated for that condition. Treatment for unrelated physical conditions still requires consent.
- Public health risks: If a person is a risk to public health as a result of specific infectious diseases, such as tuberculosis (TB) or cholera.
- Severe illness and unsanitary conditions: Under the National Assistance Act 1948, a person who is severely ill or infirm and living in unsanitary conditions can be taken to a place of care without their consent.
You can always talk to the clinician providing your care if you have any concerns regarding consent.
Consent and Life-Sustaining Treatments
If a person is being kept alive with supportive treatments—such as lung ventilation—without having made an advance decision, a decision about continuing or stopping treatment must be made based on the person’s best interests.
Healthcare professionals will discuss the issue with relatives and friends to help reach a decision. They will consider the person’s potential quality of life, how long they may live if treatment continues, and the chance of recovery. If an agreement cannot be reached, the case may be referred to the courts.
Complaints
If you believe you have received treatment you did not consent to, or if you are unhappy with the consent process, you can make an official complaint. Please write to our Practice Manager, who will assist you with our Complaints Procedure.