Obtaining Consent For Medical Procedures

Patients have the right to self-determination and individuals should have control over their own lives. With respect for human autonomy comes respect for patient rights. Apart of the nurses job is to promote, advocate and protect the rights, health, and safety of our patients. Patients have the right to determine their health needs, make informed decisions, and the right to information regarding their treatment and also the refusal of treatment. Nurses are obligated to know the rights of a patient and to make sure the patient understands their treatment plan. Supporting patient autonomy includes making decisions in the best interest of the patient, considering their values and recognizing differences between cultures. In the treatment

There are a number of legal and ethical duties expected of nurses. Most of these involve care for patient’s autonomy and confidentiality despite the medical care. Failure to act regarding these can give rise to liability. One aspect of Patient’s autonomy involves giving or withholding his consent about treatment. This paper takes into account ‘consent’ as the aspect of law regarding nursing.

According to the Oxford Dictionary consent is defined as ‘giving permission for something to happen or agreeing to do something’. They define confidentiality as ‘entrusted with private information and if something is intended to be kept secret or in confidence’ (Soanes and Hawker, 2005). As a healthcare professional consent and confidentiality are in place as protective vices, by gaining consent and keeping a patients confidentiality it protects both the patient and the healthcare professional. There are three types of consent: Verbal consent, consent in writing and implied consent. Depending on the situation each type of consent may not be acceptable. For example if a procedure is putting a patient at risk, is complex or invasive for example an operation, written consent is

This information must be easy for the patient to understand and must also be correct and truthful (RCN 2013). The Department of Health define consent as allowing a capable individual to make their own decisions about their health care without being pressured into making any decisions from others such as friends, family and health care professionals. In the adult nursing field it is legal and ethical to gain valid consent before starting a medical procedure, or providing care. This shows that the individuals rights have been respected which is good practice. If a healthcare professional did not respect an individual’s choices they could be accountable to legal proceedings. In common law touching or performing an act of care on a patient without valid consent can be classed as a criminal offence or battery. If a healthcare professional was not following the legal practice regarding consent then the individual may be faced with a criminal offence and disciplinary action will take place (Dimond 2009). The Human Rights Act states that all healthcare professionals should never judge an individual on their sex, race, religion, social origin, language or any other status.

Sule stated that, “The Patient Bill of Right adopted by American Hospitals Association states that ‘a patient possesses the right to be informed of the medical consequences of his or her actions and decisions and refuse treatment to the extent permitted by the law’. However, this is true only if the patient is in position to understand the consequences of his treatment. Incompetent, senile patients neither have the correct judgment regarding which treatment is appropriate for them, nor are they in a state of understanding the implications of their treatment. In such case, their willingness to grant or deny consent cannot dictate the course of treatment.” Problem with the Act is being able to find that the patient component enough to make such a call. Another issue that Sule stated was on confidentiality and autonomy. According to Sule, “This is another ethical issue erupting from the conflict of patient's rights and professional ethics in nursing job and profession. The Patient Bill of Right makes it mandatory for the medical practitioners to reveal the form and extent of the ailment along with the course of treatment to be undertaken by the practitioners. However, this law of autonomy clashes with the nursing ethic that the professional should maintain high degree of confidentiality regarding the patient's health and treatment.” This can cause conflicting issues in the NP’s

Another issue with the implementation of Informed consent arises when the patient waives the right to Informed consent and leaves the right to make the decision on the physician. Though legally correct, this can cause psychological stress for the physician especially when the decision is about a life threatening medical condition. Moreover, this also makes the patient vulnerable to abuse. (Manthous, DeGirolamo, 2003)

Patient informed consent refers to the situation where the patient is fully informed on the consequences of their health care decision after which the patient gives the decision. For there to be informed consent, there are five elements that must be discussed. The first is the nature of the patient's decision then the applicable alternatives to the proposed intervention. Third are the risks, benefits and uncertainties associated with each of the alternatives. Fourth is the assessment of the patient's understanding and last is the acceptance of the intervention or an alternative by the patient. Before the patient's consent is considered to be valid, the patient's competency to make the decision must be addressed. The criteria for evaluating the patient's competency is clearly stated in section 3 of the 2005 Mental Capacity Act which states that provided the person is able to understand, retain and use information provided and to communicate their decision in any way such as talking or sign language, they are competent to make a decision. If a patient is treated against their refusal to consent, it amounts to the tort of battery or can also be considered the crime of assault. In addition to this, laws that touch on human rights reinforce the importance of the protection of the physical integrity of the individual in terms of their right to respect of their private life. Therefore, refusal of medical treatment is a human right.

This paper will critique a qualitative research study published in the Journal of Medical Ethics in 2004, By Dr Helen Aveyard, about how nurses manage patients who refuse nursing care procedures. The article explains how nurses view informed consent as not being essential to nursing care procedures.

Nurses are always the front line care giver of patients. A review of literature of nursing ethics about informed consent has been performed. It strongly demonstrates the importance of informed consent and that nurses are the key players for the advocacy role to protect the patient’s right.

The main focus of the article is to look at the absolute value of patients’ confidentiality. Blightman et al. look at the pros and cones of breaking patient’s confidentiality and conclude that a breached of confidentiality is in order when it is necessary to obtain consent, as required by law, or when it is in the best interest of the public. The article is useful to my subject, since it examines in details the main issues involving the safeguard of patients’ information. In addition, the authors define confidential information, looks at breaching confidentiality for consent, audits, protection of children, disclosure to family and friends, statutory disclosure, prevention of crime, public interest, public safety, public health, and disclosure to the media. The paper publication is Continuing Education in Anaesthesia, Critical Care & Pain, which s a joint publication of the British Journal of Anaesthesia and The Royal College of Anaesthetists in the UK. It is also the official journal of The Faculty of Pain Medicine and The College of Anaesthetists of Ireland. Publication in such an esteemed journal requires utterly scrutinized of reliability and credibility of the information provided. I found the article educational and thorough in its coverage of aspects of breach of patient information. It is also well written and easy to understand.

Nurses are subject to a plethora of legal, ethical, and professional duties which can be very challenging on a day to day basis. Some of these duties include respecting a patient 's confidentiality and autonomy, and to recognize the duty of care that is owed to all patients. As nurses our duties are always professional; however there are legal implications if these duties are breached. We also must consider when it is okay as nurses to breach these duties and therefore ethical issues arise. As nurses one of our main priorities is to advocate for our patients, without our own personal feelings on the matter taking over.

Consent can be quite tricky, a legal minefield for healthcare teams, this is due to the patients who will give or refuse to give private information about themselves who is legally competent but

At a practice level, the importance and guidance of the Code of Conduct, Code of Ethics and NPA are demonstrated on a daily basis with regard to the issues of documentation, informed consent and open disclosure, and confidentiality. With respect to documentation, nurses must be able to document patient assessments and responses in an accurate, comprehensive and confidential manner and record all observations objectively. Informed consent and open disclosure are also major legal issues nurses face daily. It refers to the communication between the patient and health professional that results in the patient's agreement to undergo a specific procedure and requires that the patient has thoroughly understood the procedure, implications and risks prior to giving written consent.

Blackwell, w. (2014) states that we live in a society governed by an excessive extent of rules and regulations. Many of these rules apply to every individual within society for example rules relating to the use of public services; while other rules will focus and apply only to specific groups of individuals such as healthcare professionals. The aim of this assignment is to discuss the concept of consent in relation to the role of the nurse, with the purpose to demonstrate the ethical and legal implication of consent on nursing and professional practice.

The health care industry continually deals with the lives of individuals and is bound by the ethical and legal aspects that influence decisions of health care professionals in their clinical practice. This essay aims to discuss the various issues and ethical dilemmas that arise with regards to the consent of consumers. In the attempt to explore these points, different literatures are used to shed light on this topic. This paper begins by defining what consent is and the role of nurses or the health care team in being an advocate of the patient when requiring consent. It moves on with the discussion of ethical frameworks, which are recognized nationally and internationally, as these carry significant influences in health care decision-making. The essay also brings out the essence of ethical theories and its relevance to consent giving. It then tackles the similarities and differences of the Code of Ethics and ethical guidelines relevant to both nursing and midwives as both professions work closely in the care of mothers, children and families. Issues and views from experienced professionals in these fields are presented and critically compared. It then considers both ethical and legal aspects, which seeks arguments and rational implications. The last topic points to the social and spiritual factors pertinent to consent that impact the society particularly on the care of patients and concludes by summarising discussed points and arguments about consent.