Your treatment, your choice, your decision
We need your agreement before a doctor, nurse, or anyone looking after you examines or treats you. We call this agreement your ‘consent’.
Who can give consent?
You can give consent if you can make decisions for yourself.
- Being able to make decisions means you can understand what is involved and can think clearly about the risks and benefits of different actions.
- You must be given enough information, and should be allowed to make up your own mind without pressure from other people. We assume adults and young people (aged 16 and 17) can give consent for their own treatment unless we have reason to believe they lack capacity. If you’re under 16 staff will discuss consent with you and/or those with parental responsibility if you can’t give it yourself.
What if I can’t give consent?
You can give consent only if you have the mental capacity. This means you can: 1. Understand the information given and 2. Retain the information long enough to be able to make the decision and 3. Weigh up the information available to make the decision and 4. Communicate your decision.
If you can’t do all these things, it is called ‘incapacity’. If you lack capacity to consent to your care or treatment, for example because you are unconscious, you will need to be treated in your best interests unless this can wait until you gain capacity. This may happen in an emergency.
There are other, very specific, circumstances when medical staff might need to make decisions on behalf of an adult, for example if someone is detained under the Mental Health Act and their treatment for the condition has led to the detention.
If you’re an adult and do not have capacity to make the decision, someone can give consent for you if:
- There is a valid Lasting Power of Attorney for Health and Welfare in place with the power to consent to the treatments or
- A court has given them a welfare guardianship order for you with the power to consent to the treatment on your behalf or
- A court has given them a welfare intervention order specifically for the treatment, and the treatment is needed only for a short time.
Doctors can also treat you if you lack capacity, the treatment is in your best interests and there is no-one who can give consent on your behalf.
What information should I be given?
To help you make a decision, healthcare professionals involved in your care must give you information about the examination or treatment you are being offered in a way you understand and meets your needs. This could include audio format, British Sign Language, or a language other than English. If you require an interpreter, ask a member of staff to arrange this for you in advance. When you make an appointment, tell them which language you prefer.
You may want to know:
- Why you are being offered the examination or treatment.
- What it will involve. n What the benefits are.
- Whether there are any risks or side effects – both general and specific to you.
- How large or small the risks are.
- Whether there are any alternatives.
- What may happen if you don’t have the examination or treatment.
- The name of the doctor who is responsible for your care.
We encourage you to ask questions at any time. Someone can be with you at your appointment if you wish. This could be a friend, a relative, a partner or carer, another member of staff, or an independent representative (often called an ‘advocate’). You should be provided with information on the procedure or treatment to help you make the decision.
How do I give my consent?
For most simple procedures you only need to say that you agree and we will then be able to go ahead with your treatment. For more complicated procedures, including any that need sedation or an anaesthetic, we will ask you to sign a consent form confirming your agreement. We will usually do this when you visit the outpatient clinic. You have a right to have a copy of the consent form. You will then be asked to confirm that you want to go ahead on the day of your admission to hospital.
Can I refuse examination and treatment?
If you have capacity, you can refuse an examination or treatment at any time, even if this means your health, or the health of your unborn baby, may be seriously harmed. It’s important that you understand what may happen to you if you decide not to have the examination or treatment. If another treatment can be used instead, you should be given information about it. However, you can’t insist on a particular treatment if the NHS health professionals involved in your care don’t think it will help you.
What if I change my mind?
You can change your decision about agreeing to an examination or treatment at any time, even after you’ve signed the consent form, but you need to let us know and we will talk with you about your options.
Ask 3 Questions
Sometimes there will be choices to make about your healthcare. If you are asked to make a choice, make sure you get the answers to these three questions.
- What are my options?
- What are the benefits and risks of these options to me?
- How do I get support to help me make a decision that is right for me?
Shared decision making
Other questions I would like to ask during my consultation:
You are welcome to bring a relative, carer or friend with you to the appointment.
- You have the right to understand your medical condition and choose from the treatment options offered.
- You may choose not to have any treatment.
- We will support and guide you through the consent process and will respect your decision.
- We encourage you to ask questions at any time.
If you or the individual you are caring for need support reading this leaflet please ask a member of staff for advice.
© North Bristol NHS Trust. This edition published May 2019. Review due May 2021.NBT003220