Decision making and consent

Taking a proportionate approach

5

Not every paragraph of this guidance will be relevant to every decision that you make with or about a patient. Your judgement about how to apply the guidance will depend on the specific circumstances of each decision, including:

  1. the nature and severity of the patient’s condition and how quickly the decision must be made* 
  2. the complexity of the decision, the number of available options and the level of risk or degree of uncertainty associated with any of them
  3. the impact of the potential outcome on the patient’s individual circumstances
  4. what you already know about the patient, and what they already know about their condition and the potential options for treating or managing it
  5. the nature of the consultation.
*i

See also paragraphs 62–64 on Treatment in emergencies.

6

Obtaining a patient’s consent needn’t always be a formal, time-consuming process. While some interventions require a patient’s signature on a form, for most healthcare decisions you can rely on a patient’s verbal consent, as long as you are satisfied they’ve had the opportunity to consider any relevant information (see paragraph 10) and decided to go ahead.

Although a patient can give consent verbally (or non-verbally) you should make sure this is recorded in their notes.*

*ii

Although a patient can give consent verbally (or non-verbally) you should make sure this is recorded in their notes. See also paragraphs 50–53 on Recording decisions for more information.

7

For some quick, minimally or non-invasive interventions – particularly examinations – it would be reasonable to rely on a patient’s non-verbal consent. Examinations are a necessary part of diagnosis, and it’s reasonable to believe that a patient presenting for a consultation wants to be diagnosed.

However, even for such routine procedures you should:

  1. explain what you’re going to do and why
  2. make clear the patient can say no, and stop immediately if they do
  3. be alert for any sign that they may be confused or unhappy about what you are doing.