As an allied health practitioner, it’s important for you to understand consent thoroughly, and practice it with the patients you interact with at all times.
Power dynamics with healthcare
When thinking about consent, an important question should be asked: who has the power? Practitioners hold inherent power over patients—practitioners are asked for help, they make decisions about patients' bodies and minds, and they give advice and therapeutic recommendations. Because of the imbalance in power within the practitioner-patient relationship, it is even more important for patients to have the opportunity to say no or ask questions during consultations.
What does ‘consent’ in healthcare mean?
As a practitioner, you must ask your patient to give consent for most activities. Consent to healthcare treatment means a person must give you their permission before they receive any treatment.
We all practice asking for and giving consent every day. “Do you want sugar in your tea?” “Can I come over a bit later?” “Please take your shoes off at the door.” These are all basic examples of consent in daily life.
In consent, we:
Ask, and don’t assume, if a person wants or needs something.
Understand that our patients have the right to voice if they do or do not want something.
Stay mindful that our patients can withdraw their consent at any time if they have changed their mind (but they cannot retract consent for something that has already occurred).
Generally, consent should progress as a conversation.
Implied consent is not enough to fully consent to something. It is integral for health professionals to explain to their patients what is going to occur within any given procedure, such as undressing, areas of a patient’s body that will be touched and examined, and what the treatment involves.
Giving this information to your patient alongside their agreement to rational treatment is known as informed consent. This consent can be verbal or written. I recommend that this is best to be written, so that you have a record of it.
Informed consent should include:
What the practitioner is going to do
What the patient may be asked to do
Benefits of the treatment
Risks (if any) in undertaking the treatment and risks (if any) if treatment is not proceeded with
Alternatives to the treatment
Time for the patient to ask questions
Being aware of associated risks, and having time to ask questions, is vital to a patient fully consenting to treatment.
When obtaining written consent, aspects of care should be discussed with the patient before they sign the form, otherwise they can’t know what they have consented to. Take the form into the room with you and have a conversation before they sign.
Part of informed consent is the knowledge that consent is an ongoing and continual agreement to the process taking place. Even if you have asked your patient to sign a consent form, or they have previously said yes to proceeding with treatment, they have the right to change their mind and halt the process at any time.
How to practice ‘good’ consent
When asking a patient to sign something, ensure you give them time to read, understand, and discuss the document without rushing them.
Encourage questions from your patients —what may be common language for you may be ‘jargon’ to them, and they may not understand your terminology.
Explain the next steps in a treatment process before they happen.
Remember that consent is a conversation, and it is ongoing. The conversation does not end after the first treatment you give a patient, or after a form is signed. Practice it with new clients or with ones you’ve been treating for years.
We all want to create respectful and safe environments in our work. But how active are we in this process, and do we assume others think of us as an inclusive person without us actually doing anything to show it?