Consent guidance: Expressions of consent

1. 44. Before accepting a patient’s consent, you must consider whether they have been given the information they want or need, and how well they understand the details and implications of what is proposed. This is more important than how their consent is expressed or recorded.

2. 45. Patients can give consent orally or in writing, or they may imply consent by complying with the proposed examination or treatment, for example, by rolling up their sleeve to have their blood pressure taken.

3. 46. In the case of minor or routine investigations or treatments, if you are satisfied that the patient understands what you propose to do and why, it is usually enough to have oral or implied consent.

4. 47. In cases that involve higher risk, it is important that you get the patient's written consent. This is so that everyone involved understands what was explained and agreed.

5. 48. By law you must get written consent for certain treatments, such as fertility treatment and organ donation. You must follow the laws and codes of practice that govern these situations.

6. 49. You should also get written consent from a patient if:

7. 1. a. the investigation or treatment is complex or involves significant risks
   2. b. there may be significant consequences for the patient’s employment, or social or personal life
   3. c. providing clinical care is not the primary purpose of the investigation or treatment
   4. d. the treatment is part of a research programme or is an innovative  treatment designed specifically for their benefit.

1. 50. If it is not possible to get written consent, for example, in an emergency or if the patient needs the treatment to relieve serious pain or distress, you can rely on oral consent. But you must still give the patient the information they want or need to make a decision. You must record the fact that they have given consent, in their medical records.