Every treatment or procedure requires the patient’s consent.
Consent is a contract whereby the
patient gives permission to a health care professional to perform a medical service.
This consent can be either expressed in a patient agreeing verbally or in writing, to a procedure
or treatment. The consent can also be implied, as in the case of taking a blood pressure and the
person rolls up their sleeve, or the patient allowing you to position their ankle after explaining
the procedure. In the situation of an unconscious emergency victim, hospital staff can perform
whatever necessary treatment or procedure, even if the patient cannot give consent.
Required:
Ethics in Health Care: a Canadian Focus
Chapter 4: Informed consent
Chapter 5: Substitute decision-making
Many procedures performed in diagnostic imaging departments require special consent forms
to be signed by the patient, or in the case of minor children, by their parents or legal
representative. You must be familiar with the procedures that require special consent forms and
not confuse these with the general consent forms that are often signed when the patient enters
the hospital, because the general forms are not valid if a special informed consent is required.
Although these special consent forms are usually signed before the patient comes to your
department, it is your responsibility to recheck the patient’s chart/record to be certain that this
has been accomplished. You should also ascertain that the patient understands what is going to
be done and the essential nature of the choices available to him. If the patient, (or their
parent/legal representative) deny knowledge of the procedure, you must notify the doctor
(Radiologist) of this. The procedure should be postponed until the matter is satisfactorily
resolved. This is very important as the lack of informed consent is considered battery, even if
the medical procedure is in the patient’s best interest.
Consent must be obtained prior to the patient receiving any anaesthetizing medications as they
may alter the patient's ability to comprehend the procedure and make an informed decision.
Special Considerations: Minors
There is no specific age that defines a minor when it comes to consent for treatment. Generally
speaking, a minor may consent to their own treatment if they fully understand both the risks
and benefits of a treatment to be able to make an informed decision. If the minor is unable to
make an informed decision on their own, then consent must be signed by the parents or legal
representative for the child. If either of the two is not present then authority is passed to a
person who has the power of attorney for the individual’s personal care. If a child is travelling
on their own, then a legal guardian can supply written permission for consent to any medical
treatment along with the child.
For further clarification regarding consent, consider the following examples while you read
Chapter 5 in your textbook:
A pediatric inpatient comes with his mother to the radiology department for a wrist exam. The
technologist explains the exam to the mother and child and confirms the order within the
patient’s chart. If neither the parent nor child refuse the exam then the technologist has
consent to proceed.
A pediatric outpatient comes with his mother to the radiology department for a wrist exam. The
technologist confirms the exam with the mother and child; neither of them refuses the exam. In
the x-ray room the child rolls up his sleeve. The technologist has consent to perform the exam
Read more about Children, Adolescents and Consent; click on the links below.
The Infants Act of British Columbia
The Infants Act, Mature Minor Consent and Immunization
Special Considerations: Mentally Ill,
Disabled, & Challenged
Mentally disabled individuals are protected under the same fundamental principles of ethics
and law whereby everyone has the right to decide what happens to their body. When an
individual is mentally incompetent then the decisions regarding medical care should follow what
was expressed to others when the individual was mentally competent or follow an advance
directive. An advance directive is a document that is written by a mentally competent individual
which details specific medical treatments that the individual would proceed with were they later
mentally incompetent and unable to communicate their decisions.
Since there are many other issues surrounding consent, you should refer to the specific
agency's policy if situations arise during your clinical experience that you are not familiar with.
Health Care Consent with Physical Distancing: Understanding Decision-Making Rights in Canada
