What is informed consent?
Informed consent is the process of exchanging information so that a patient / consumer can make an informed decision about their healthcare options, including the option of refusing the treatment, procedure or intervention.
Why is it necessary?
Every competent person has the right to agree or refuse (or withdraw consent) to have a proposed treatment, procedure or intervention.
To do this a patient must be accurately and adequately informed about their condition, the proposed treatment, procedure or intervention, and be provided with information in a language, style and form that can be easily understood.
Patients also have a right to have another person or persons present to provide support during discussions related to the proposed treatment, procedure or intervention.
When is consent required?
Informed consent must be obtained for each proposed treatment, procedure or intervention. In situations where a series of similar treatments or procedures are undertaken (for example dialysis or counselling), a full discussion will be held prior to the commencement of treatment to obtain consent. Should the agreed plan change significantly, a new consent process will be undertaken.
Note: There are a few situations where individuals may be treated without consent, such as in an emergency or under the Mental Health (Compulsory Assessment and Treatment) Act 1992.
Levels of consent
Written consent is required in situations where:
- patient is to be placed under general anaesthetic or sedation
- there is a significant risk of adverse effects on the patient
- the procedure or treatment is experimental
- body parts or tissue are to be removed
- blood components and/or products are to be used
- a student is to perform an intimate examination
- when either party requests it
You will be asked for your written consent by completing this consent form.
Verbal consent is required in all other circumstances and the discussion and decision should be documented in the patient’s clinical record.
Consent for children and young people
For children and young people under the age of 16, consent may be given by:
- a guardian of the child
- a person who has been acting in place of a parent, if there is no guidance in NZ or no guardian can be found with reasonable diligence who is capable of giving consent
- a District Court Judge or the chief executive of Child, Youth and Family if there is no person in NZ who has been so acting
In general, the child will be involved as much as possible (depending on their age) and information will be given to the child in a way that they can understand.
A young person aged 16 years and over can consent to their treatment as if they were an adult.
Consent for patients who are incompetent
Consent for patients who are incompetent may be given by:
- a welfare guardian appointed under the Protection of Personal and Property Rights Act 1988
- an attorney under an activated enduring power of attorney in respect of care and welfare
If there is no welfare guardian or attorney under an enduring power of attorney, treatment may be provided under Right 7(4) of the Code of Health and Disability Services Consumers’ Rights if:
- the treatment is in the best interests of the patient; and
- attempts have been made to find out what the patient would have wanted if s/he were competent; or
- if it is not possible to find out what the patient would have wanted, the views of people interested in the patient’s welfare have been taken into account
Key contact person
Patients will be asked to nominate someone as their ‘key contact person’ when they are admitted to hospital. Usually this is a spouse or partner or close family relative. The ‘key contact person’ acts as a contact or reference person while the patient is in hospital but does not have any special legal standing. For example the ‘key contact person’ does not have the right to consent to medical care or make other decisions on behalf of a patient.
Teaching and observers
Our healthcare settings are learning environments where clinical teaching and learning occur as part of day-to-day practice as well as formal teaching. As a patient you have a right to consent to or decline involvement in teaching, including the presence of observers during treatment or examination.