You, your staff, systems and site

Patient consent

Before performing a procedure, it is important to receive consent from the patient:

With invasive and surgical procedures, it is particularly important to give a full explanation of what you are proposing, your reasons for wishing to undertake the procedure and what you hope to find or accomplish. Ensure that you use language that can be understood; draw pictures and use an interpreter, if necessary. Allow the patient and family members to ask questions and to think about what you have said. In some situations, it may be necessary to consult with a family member or community elder who may not be present; allow for this if the patient’s condition permits. If a person is too ill to give consent (for example, if they are unconscious) and their condition will not allow further delay, you should proceed, without formal consent, acting in the best interest of the patient. Record your reasoning and plan.

Be attentive to legal, religious, cultural, linguistic and family norms and differences.

Some hospitals require patients to sign a document indicating that the surgical procedure and potential complications have been explained and that permission to proceed has been granted. This paper is then included in the patient’s record. If this is not a formal requirement in your hospital, document the conversation in which consent was given and include the names of people present at the discussion.

Informed consent means that the patient and the patient’s family understand what is to take place, including the potential risks and complications of both proceeding and not proceeding, and have given permission for a course of action. It should be a choice made free from coercion.

In our jobs as health care providers, we sometimes experience situations which demand things with which we, as individuals, may feel uncomfortable. Our duty as professionals to provide service and care can come into conflict with our personal opinions. It is important to be aware of these feelings when they occur and to understand where they are coming from. If we are asked to care for someone who is alleged to have committed a crime, it is not our responsibility to administer justice. However, it is our responsibility to provide care. This can be difficult, but it is important to recognize that:

Our job is not to judge, but to provide care to all without regard to social status or any other considerations.

By acting in this way, we will be seen to be fair and equitable by the community we serve.