Everything You Need To Know About Informed Consent

February 27, 2018

Informed consent is the patient's approval (or that of the patient's legal representative) to have his or her body touched by a specific individual. Consents or releases, are legal documents  that indicate the patient's permission to perform surgery, perform treatment, or give information to a third party. 

Informed consent indicates the patient's participation in the decision regarding health care. 

 

 

 

 

 

 

Types of consent: 

1. Admission agreement: Identify the health care agency's responsibility to the patient. Obtained at the time of admission. 

2. Blood transfusion consent:  The patient was informed of the benefits and risks of transfusion. Some religions prohibit receiving blood transfusion, even if life threatening situation (e.g. Jehovah's Witnesses). 

3. Surgical consent: Physician, surgeon, or anesthesiologist who performs the operation or procedure is responsible for explaining the procedure, its risks and benefits, and possible alternative options. Surgical consent is obtained for all surgical procedures or diagnostic tests that are invasive. 

4. Research consent: Obtains permission from the patient regarding participation in a research study. 

5. Special consent: Special consent are required for the use of restraints, photographing the patient, disposal of body parts during surgery, donating organs after death, or performing an autopsy. 

 

The patient must be informed, in understandable terms, of the risks and benefits of the surgery or treatment, what the consequences are for not having the surgery or procedure  performed., treatment options, and the name of the health care provider performing surgery or procedure. 

 

A patient's questions about the surgery or procedure must be answered before signing the consent. 

 

A consent must be signed freely by the patient without threat or pressure and must be witnessed (witness must be an adult). A patient who has been medicated with sedating medications or any other medications that can affect the patient's cognitive abilities should not be asked to sign a consent. 

 

Legally the patient must be mentally and emotionally competent to give consent. 

 

Mentally or Emotionally Incompetent Patients

 

1. Declared incompetent

2. Unconscious

3. Under the influence of alcohol or drugs

4. Chronic dementia or other mental deficiency

 

If the patient is declared mentally or emotionally incompetent, the next kin, appointed guardian (appointed by the court), or the durable power of attorney has legal authority to give consent. 

 

Next oF Kin Order of Priority:

1. Spouse

2. Adult son or daughter

3. Either Parent

4. Adult brother or sister

5. The Guardian

6. Any other person authorised by law or under legal obligation

 

A competent patient over 18 years of age must sign the consent. 

 

Minors: 

  • A minor is a patient under legal age as defined by state statute (usually younger than 18 years)

  • A minor may not give legal consent, and consent must be obtained from a parent or the legal guardian. 

  • Parental or guardian consent should be obtained before treatment is initiated for a minor except in the following cases: In an emergency situations in which the consent of the minor is sufficient, such as treatment related to substance abuse, treatment of sexually transmitted disease, human immunodeficiency virus testing and acquired immunodeficiency syndrome treatment, birth control services, pregnancy, or psychiatric services, emancipated minor, or if court order or other legal authorization has been obtained. 

Emancipated minor: 

  • An emancipated minor has established independence from the parents through marriage, pregnancy, service in the armed forces, or by a court order. 

  • Considered legally capable of signing an informed consent. 

See more about consent on the link below: 

When a nurse is involved in the informed consent process, the nurse is witnessing only the signature of the patient on the informed consent form. 

 

An informed consent can be waived for urgent medical or surgical intervention as long as institutional policy so indicates. 

 

A patient has the right to refuse information and waive the informed consent and undergo treatment, but the decision must be documented in the medical record. 

 

A patient may withdraw consent at any time. 

 

Reference: 

Saunders comprehensive review for the NCLEX-RN examination (Linda Anne Silvestri)

 

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