With no unified consent policy in existence for the health and social care sectors, the National Consent Advisory Group ("NCAG") was established to draft a policy framework to cover all aspects of consent. In May, a draft policy was produced for consultation, with a view to publishing the final documentation in September of this year. This article examines some of the most notable aspects of the draft policy (the full text of which can be accessed at www.hse.ie).
Valid and informed consent – the presumption of capacity
The draft policy document reaffirms the presumption that all adult patients have capacity and should not be challenged without adequate reason, and that no other person can give or refuse consent on behalf of a capable adult patient. The draft policy also notes that while family members have an important role to play in supporting an adult during the decision making processes, a voluntary decision by a capable adult to refuse treatment must be respected, even where this will likely lead to death.
For practitioners, the draft policy sets out the type of information which must be provided to patients in order to obtain valid and informed consent. This includes the acknowledgement that a patient must be given all information that a reasonable patient would expect in the situation, and advises healthcare professionals to be cognisant of potential biases in how risks are expressed and to give information in a balanced manner.
Furthermore, the draft policy notes that the healthcare or social care professional providing the service is responsible for ensuring that adequate consent has been provided. Consenting the patient or service user may be delegated to another suitably trained and qualified colleague who has sufficient knowledge of the proposed intervention and associated risks / benefits.
Children and minors – how should consent be obtained?
In relation to children, the draft policy proposes that, in general, consent by one parent / guardian will be sufficient for healthcare or social intervention regarding a child. However, in the case that a proposed intervention may have profound and irreversible consequences, consent should be sought from both parents or guardians.
For minors under the age of 16, the draft policy advocates that best practice is to encourage the minor to discuss the matter with a parent or guardian. Healthcare and social interventions will only be provided to minors under 16 without the knowledge or...