Consent is the principle that a person has to give their permission before they receive any type of medical treatment or agree to accept a service.
The principle of consent is enshrined in international human rights law.
What constitutes consent?
In order for consent to be valid, it must be both voluntary and informed and the person consenting must have the capacity to make the decision. These terms are explained below.
Voluntary: the decision to consent or not consent to treatment or services must be made alone, and must not be the result of pressure by service providers, staff, friends or family.
Informed: the person must be given full information about what the treatment or service involves, including the benefits and risks, whether there are any other reasonable alternatives and what could happen if treatment/service does not go ahead.
Capacity: the person must be capable of giving consent, which means that they are able to understand the information that is given to them and they are able to
use it to make an informed decision.
There are two situations where it is important to ensure deaf people are fully informed before giving consent:
• In health settings when considering whether or not to accept treatment;
• In financial settings considering personal loans, credit card, hire purchase, mortgage or other financial agreements.
Scottish Council on Deafness recommends that:
1. All the relevant information must be provided in the format the deaf person requests.
2. No relevant information should be withheld from the patient.
3. The service provider should provide the appropriate registered professional communication support to be able to discuss the issues with the deaf person and answer their queries. Family members or friends should not be used to provide communication support. If it is difficult to book appropriate registered professional communication support for a particular appointment or meeting, then the date of that appointment or meeting should be changed to one where communication support is available.1
4. Time should be set aside so that the deaf person can ask questions and receive the answers needed from a suitably qualified or informed person.
5. If a deaf person requires emergency treatment to save their life, and they are unable to give consent as a result of being physically or mentally incapacitated (for example, they are unconscious), treatment will be carried out. Once they have recovered, the reasons why treatment was necessary will be fully explained. It is vital that the appropriate communication support is provided for this.
6. The deaf person has the same rights to withdraw their consent to treatment or the provision of services as their hearing peers. This is a right that can be used even when the provision of services or medical treatment has begun.
7. In financial settings, a ‘cooling off’ period will usually apply when entering into a contract for the provision of goods or services. The service provider should provide the means for the deaf person to make direct contact in order to cancel the contract.
The main exceptions where medical treatment can go ahead without consent is if a person does not have the mental capacity (the ability to understand and use information) to make a decision regarding their treatment. In this case, the healthcare professionals who are treating that person can provide treatment if they believe that it is in the person’s best interests or in an emergency to save the person’s life.
For further information visit: www.nhsinform.co.uk
1 See our Information Sheet on Communication Support.