Informed Consent e

Guide to Good Nursing Practice
Informed Consent
Preamble
Respecting the right of every client to self-determination is a basic ethical principle that every
nurse should observe. It is also a legal right of each client to decide what can and cannot be
done to his/her own body in the treatment process. Therefore, when providing nursing care
or treatment, a nurse has the legal and ethical obligations to obtain consent from client.
Care or treatment without consent may amount to civil or criminal liability.
Definition
Informed consent is a process of communication between a client and a member of the
healthcare team that results in the client’s authorization or agreement to undergo a specific
intervention/procedure. It is more than simply getting a client to sign a consent form.
Principles
In obtaining informed consent from the client, the nurse needs to consider the following:
1. Client receives sufficient information before making a decision for an informed consent.
2. Client is mentally competent when giving consent.
3. Client gives the consent voluntarily and is not under any duress.
4. Consent is given to cover a specific intervention/procedure.
5. Client has the right to refuse or withdraw consent to treatment.
6. If it is in the best interest of the client or the public, medical examination/treatment can
be done without consent under the following situations:
6.1 Prevention of the spread of infectious diseases (Chapter 141B, Laws of Hong Kong).
6.2 Provision of emergency treatment under the common laws e.g. in unconscious adult
client or in conscious client but incapable of giving consent.
7. Age limit is not the primary concern for a valid informed consent. The general
principle is that the client is able to understand fully the information given and its
implications when he/she gives consent by himself/herself.
8. Proper documentation is an integral part of the whole consent process.
Responsibilities of the nurse

1. Information provided in informed consent
The nurse provides adequate information specific to a client and the intervention/
procedure for an informed consent. Examples of the information are:
- The nature of client’s condition.
- The nature, benefits, possible risks and consequences of the intervention/procedure.
- Available alternatives to the proposed intervention/procedure.
- The likely outcome if the intervention/procedure is not taken.
2. Implied consent
The nurse accepts it as an indication of implied consent to an intervention/procedure
based on the mere fact that the client presents himself/herself to the nurse and cooperates
in going through the procedures. The intervention/procedure may vary from simple ones,
such as temperature taking, inspection, palpation, percussion and auscultation, to invasive
ones such as blood taking. For complicated procedures, expressed permission from the
1
Developed by the Professional Development Committee of

the Nursing Council of Hong Kong
client is required. The nurse explains to the client the subsequent actions.
3. Written consent
The nurse obtains written consent, or to ensure written consent is obtained, before
carrying out certain treatment/intervention with particular consideration on the
complexity, risks or consequences of the procedures. Examples of these situations are:
- the treatment/intervention is complex.
- the treatment/intervention carries significant risks.
- the treatment/intervention involves anaesthesia or sedation.
- the treatment/intervention might have significant consequences on the client’s
employment, social or personal life.
4. Communication
The nurse, as a member of the healthcare team, addresses to the client’s needs and
preferences for information content. The nurse explains by using language that the
client can understand. He/she encourages the client/relative to express feelings, and to
talk about concern, fears, anger and anxieties. As a client advocate, the nurse assures that
adequate time is given for the client to consider the choice of treatment. The nurse uses
fact sheet, where available, to provide information on particular procedures to the client.
The fact sheet is to be updated regularly with indication of sources and revision date.
5. Witness of consent
It is preferred for a nurse to engage a person to be a witness in the process of obtaining
informed consent for treatment/procedure. In circumstances that the nurse signs as a
witness, he/she has to engage in the entire process of informed consent, from the
explanation-giving to the signing of the consent form.
6. Documentation
The nurse ensures proper documentation, which is an integral part of the whole consent
process. The essential elements include:
6.1 Indication(s) of intervention.
6.2 Explanation of the intervention.
6.3 Explanation of the consequences if intervention is not taken.
6.4 Post-intervention plan.
6.5 Potential risks.
6.6 Client's response to the explanation.
7. Right of refusal or withdrawal of consent
The nurse respects the right of client to refuse or withdraw consent given at any point of
time and on any ground. The nurse documents the decision of client in these situations.
8. Consent in minors
There is no age limit for consent in minors under18 years old. A minor can give consent
if he/she is competent to understand fully the proposed treatment and intervention, its
consequences and possible benefits and risks. Parental involvement is suggested when a
minor gives consent, unless it is not in the minor’s best interests to do so. A person with
parental responsibility may give consent if a minor lacks the capacity.
9. Mentally incapacitated client
For the provision of treatment to a mentally incapacitated client, the nurse makes
references to Part IVC of the Mental Health Ordinance (Chapter 136, Laws of Hong
Kong). The nurse may need to consult Guardianship Board to protect the client's
interests.

Bibliography
Canadian Nurses Association. (2000). Working with Limited Resources: Nurses’ Moral
Constraints. Ethics in practice.
Hospital Authority. (1998). Patients’ Charter. Hong Kong.
Hospital Authority. (2002). Risk Management Release. The Newsletter for the HAHO Risk
Management Committee. Issue No. 8. October. Hong Kong.
Hospital Authority. (2003). Legal Principles on Informed Consent. Hong Kong.
Medical Council of the Hong Kong. (2000). Professional Code and Conduct for the
Guidance of Registered Medical Practitioners. Hong Kong.
Nursing Council of Hong Kong. (2002). Code of Professional Conduct and Cede of
Ethics for Nurses in Hong Kong. Hong Kong.
Pang, M.C.S. (1999). Protective Truthfulness: The Chinese Way in Safeguarding Patients
in Informed Treatment Decision. Journal of Medical Ethics, 25, 247-53.
Registered Nurses Association of British Columbia. (2005). Nursing Practice Guideline.
Wong, K.S. (2002). Consent. Medical Section. 7:10. Hong Kong.
Working Group Members

Convenor: Ms Helena LI, Shatin Hospital
Members: Ms Samantha CHONG, Kwong Wah Hospital
Prof. Samantha PANG, Hong Kong Polytechnic University
Mr. William POON, United Christian Hospital
Prof. Diana LI, Chinese University of Hong Kong
Mr. PANG Shu-wing, Kwai Chung Hospital
Mr. Alfred TSE, Tuen Mun Hospital
Ms Ivy YU, Kwong Wah Hospital
Ms LEUNG Fung-yee, Princess Margaret Hospital
Ms Daisy LEUNG, Queen Mary Hospital
Ms H Y MAN, Princess Margaret Hospital
Printed in September 2006


Informed Consent e

Uploaded by

Copyright:

Available Formats

Informed Consent e

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Informed Consent e

Uploaded by

Copyright:

Available Formats

What are the principles of obtaining informed consent?

What are the responsibilities of the nurse in obtaining informed consent?

Guide to Good Nursing Practice

Responsibilities of the nurse

Developed by the Professional Development Committee of

Developed by the Professional Development Committee of

Hospital Authority. (1998). Patients’ Charter. Hong Kong.

Hospital Authority. (2003). Legal Principles on Informed Consent. Hong Kong.

Registered Nurses Association of British Columbia. (2005). Nursing Practice Guideline.

Wong, K.S. (2002). Consent. Medical Section. 7:10. Hong Kong.

Working Group Members

Printed in September 2006

Developed by the Professional Development Committee of

You might also like

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.