Patient-informed consent means patients understand the risks, alternatives and possible benefits of any treatment they receive. The Montgomery case: implications for practice. The law not only protects a person from any unwanted touch, but also from the fear of being touched. A most important way in which these rights are upheld is through the process of informed consent which can be oral or written and must be stated in each participant document or chart (American Nurses Association, 1985). Citation: Taylor H (2018) Informed consent 1: legal basis and implications for practice. No one can guarantee positive outcomes in healthcare settings, but informed consent at least ensures patients understand the risks they undertake with treatment. Person-centred care implies the centrality of the patient, who is seen as a key participant in care, rather than the passive recipient of it. Oxygen deprivation during birth resulted in severe and permanent disability for Mrs Montgomery’s son. During the later stages of her pregnancy, she told her obstetrician about her concerns that the baby’s size would make delivery difficult. As well as understanding the legal framework that underpins care, nurses need to be aware that the law can change quickly, even after long periods without changes. This article – the first in a two-part series – explores the legal principles of informed consent in adults, considers why it is fundamental to the provisio… Sidaway v Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital [1985] AC 871 reflects the view that patients cannot be expected to have the same level of knowledge as the doctors treating them, might not be able to objectively balance the risks and benefits of a particular intervention, and might place “undue significance” on certain elements of the information they are given. Regardless of the process used, the consensus is that decisions will be based on information of one kind or another, and will influence the outcomes for patients (Taylor, 2005). It will also discuss situations in which treatments and interventions may be given lawfully in the absence of consent. To work effectively, informed consent must allow patients to make the decisions right for them. Protecting patient autonomy is a key nursing role. If there is doubt as to whether consent was sufficiently informed, a decision will be made by the court (Montgomery v Lanarkshire Health Board [2015] UKSC 11; Chester v Afshar [2004]). Consent from a patient is needed regardless of the procedure, whether it's a physical examination, organ donation or something else. Tagged with: Coronavirus zone: legal and professional issues Newly qualified nurses: legal and ethical issues. This applies to all areas of life, including healthcare (Re F (Mental Patient: Sterilisation) [1990] 2 AC 1) and means patients generally have the right to make decisions about their care – for example, whether to accept a treatment or intervention – even if their “refusal may risk permanent injury to [their] health or even lead to premature death”. The Importance of Patient Informed Consent, learn more about medical malpractice insurance, The Importance of Patient Satisfaction in Healthcare, Importance of Doctor-Patient Communication. This may mean a physician explains the possible side effects, risks and benefits of a course of treatment or informs a patient of what other treatments may be available. Although not all patients want, or are able to, participate in decision making, there has been a shift towards the active involvement of patients in this area. Author: Helen Taylor is visiting lecturer at the University of Birmingham and freelance writer on health law. Why is it important? Nurses must generally obtain the patient’s informed consent before proceeding with treatment, Proceeding with treatment without the patient’s consent is, in most cases, unlawful, The law on informed consent in adults was changed by a judgement of the Supreme Court in 2015 (Montgomery v Lanarkshire), Nurses must provide patients with the information they need to make an informed decision about their care, If the necessary information to make an informed decision is not given, consent may not be valid and nurses may be acting unlawfully if they proceed with treatment. The section will also look at consent, which is all about ensuring we have permission from patients/clients to carry out tasks with, for and on them, and capacity, which relates to a person’s ability to use and understand information to make a decision and either offer or refuse consent. Mrs Montgomery, who had type 1 diabetes, was expecting her first baby; a pre-natal assessment indicated that the baby would be large. This means medical professionals must offer enough information to patients to enable them to make a choice and provide enough time, where possible, so patients don’t feel pressured. In civil cases, the claimant (usually the patie… The physician should have obtained consent before the nurse has the patient sign a form. The Society of the New York Hospital case. Research professionals, including research nurses, who seek informed consent are expected to convey information in a clear and unambiguous way, adapting “the presentation of the information to the subject’s capacities” (National Commission, 1979, Part C, para. Think about consent as a process to assure patient understanding and agreement, not just signing a form. In that case, the House of Lords made clear that a practitioner would be negligent – and in breach of their duty of care to the patient – if they failed to advise them of the risks associated with a proposed treatment. © Copyright 2015 by Arthur J. Gallagher & Co. All Rights Reserved. Informed consent does not mean simply completing and signing a consent form. Chester v Afshar [2004] does not specify the extent of the information doctors must provide, other than saying there is a “legal duty to a patient to warn him or her in general terms of possible serious risks involved in the procedure”. In the past, there was a paternalistic approach to healthcare: doctors decided not only what treatment would best fit their patients’ needs, but also what information to give to them. What can nurses do to improve informed consent? It also reduces the risk for both patient and doctor. In situations where the issue of consent has been questioned, a successful legal action requires proof that consent was not given. To recognise and uphold their patients’ rights, nurses must not only be aware of the standards set out in the Code, but also understand their legal basis. It must also be noted that the law relating to consent in children is different to that for adults, and is not covered by this article. Nurses have a legal duty to ensure they obtain informed consent from their patients before carrying out any intervention or treatment. Get notified when a new post is published. Sometimes person-centred care is not defined but, instead, is simply described in terms of patient autonomy, holistic care and primacy of patient need (Hayes, 2014). Arguably, as well as informing the clinical element of care (for example, selecting the most appropriate wound dressing), the best available evidence must also inform the wider framework for decision making (for example, determining the legality of providing treatment if the patient is unconscious and, as such, not able to give their consent). 29, 10, 45-48. doi: 10.7748/ns.29.10.45.e9443 This is important since even treatments which are meant to help a patient come with risks, and it is essential for patients to accept those risks when getting care. Although healthcare providers have a legal obligation to provide treatment for their patients and may incur liability in civil law (negligence) or even criminal law if they fail to do so, they may also be liable if treatment is given without the patient’s consent. How the law without knowing it so an emergency Employers must do their to... 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