All About Consent


Patients have the right to make decisions about their treatment.

Health care providers must get consent before providing treatment. The only exception is in an emergency. The Health Care Consent Act (HCCA) outlines the rules for obtaining consent.

For consent to be valid it must be informed and given voluntarily by a capable person.

Informed means

  • Patients understand what they are consenting to.
  • Patients must be told about the treatment: the risks, benefits, and side effects of the treatment, other options for treatment and the impact of not having treatment.

There is no minimum age of consent. Consent is based on capacity, not age.
       

Capacity

  • Presumes each person is capable, unless you have evidence otherwise
  • May mean patients can be capable of some treatment decisions but not others
  • Can vary over time

If a patient is not capable of giving informed consent, a substitute decision-maker (SDM) must be identified. Read more about their role and who can be a substitute decision-maker in the Health Care Consent Act Briefing Note.

Consent can be given expressly (either verbally or in writing) or it can be implied (by words, behaviour or circumstances).

Signing a form does not mean patient understanding.
Health care providers must have a discussion with patients and provide all the information patients need to make a decision and answer any questions they may have.

The health care provider who is giving a treatment must ensure that the patient or the substitute decision-maker has consented before the treatment is given.

  • Consent can be given for each individual treatment or for a multi-faceted course of treatment.
  • One health care provider can propose a plan or course of treatment and get consent on behalf of all the health care providers involved in the plan

Patients can refuse treatment or change their mind and withdraw consent at any time.

Health care providers must document that consent was obtained.

Tip:

Include information such as: the process followed, the date consent was obtained, who was involved in the discussion, the information relayed to the patient or substitute decision-maker, the questions asked and answered when documenting that consent was given.


Related Laws and Legislation

Related links

Having the Important Patient Conversation: 7 Things You Should Know about Consent


Consent goes beyond just having a patient sign their name on a form. It’s a process that requires a thorough conversation between the patient and person giving the treatment. This conversation must provide opportunities for the PT and the patient to discuss the issue, consider treatment options, ask questions and have those questions answered.

Here are seven things you should know about consent listed not in any particular order or exhaustive. 

  1. A patient can withdraw their consent at any time.

  2. Patients or substitute decision makers must have enough information to make an informed decision and be given an opportunity to ask questions.

  3. Consent must cover the following: Nature of treatment, benefits of treatment, risks of treatment, side effects of treatment, alternative courses of action, and consequences of not having treatment.

  4. When working with a patient who is not fluent in English, do not assume that the patient is capable or incapable of providing informed consent. Consider using an interpreter or someone else who is fluent in their language and English.

  5. Consent can be obtained by one person on behalf of a team as long as the patient can ask about specific elements of the plan being offered by a specific provider.

  6. You need to have patients consent to include a support person in his or her care. Patients have the right to make an informed choice.

  7. A physiotherapist must release a copy of the patient record to the patient, or their representative, if they request it.