Your thoughts on informed consent survey answers

The correct best answer is: Consent is a shared decision-making process following discussion.

Consent is a shared decision-making process where the patient agrees to recommended treatment following a discussion with their doctor about the risks, benefits and alternatives.

While a patient’s choice to proceed and completing documentation, such as a consent form, are parts of the consent process, the discussion between doctor and patient and shared decision-making are critical components of the process.

A patient signing and dating a consent form, verbal agreement from the patient and a patient indicating agreement through their actions (e.g. holding out their arm for their blood pressure to be checked) are all appropriate ways of providing consent.

A patient agreeing to a treatment option only after a family member expresses their preference is not an acceptable method to confirm consent as consent must be given freely and without undue influence or pressure from others, including family members. 

False 

The need to obtain patient consent applies to examinations, investigations and other treatment such as prescribing medication, as well as to procedures and surgery.

False

The consent process can be delegated to someone else, as long as the delegate has sufficient knowledge and skill to be able to have the consent discussion with the patient. The person delegated to obtain consent needs to understand the procedure/treatment and what the patient needs to know and understand about it to be able to have an effective discussion.

False 

The percentage chance of a risk occurring is not the only determining factor. The extent or severity of the potential injury and the likelihood of it occurring must both be considered. A slight risk of a serious harm may still be material to the patient.

False 

You need to discuss the general known risks, risks that are material to the individual patient as well as something the patient specifically asks about. Your discussion with the patient, gaining understanding about their condition and their medical and social history, as well as asking questions such as what the patient is worried about will help determine individual material risks.

True

While the general known risks will be the same, the material risks change for every patient based on their clinical and personal circumstances. Your discussion with the patient, gaining understanding about their condition and their medical and social history, as well as asking questions such as what the patient is worried about will help determine individual material risks.

The correct answer is: Explain the general risks involved as well as the potential risk, albeit uncertain and low-probability, of serious eye complications so they can make an informed decision. 

This is correct because vision loss is a material risk for this particular patient and therefore is important information for the patient to know to be able to make an informed decision about the procedure.

False 

Capacity is decision-specific so a patient can lack capacity for one decision but still have capacity to make other healthcare decisions.

False 

From 18 years old (or 16 years old in South Australia), patients are presumed to have capacity. Before that age, children can have capacity to consent to their own treatment as long as they fully understand what is proposed. There is no specific age at which this occurs and will depend on the child and the decision being made and is based on your assessment and clinical judgement.

The correct answer is: Proceed with the surgery based on the patient’s consent if you are satisfied he has decision-making capacity. 

A patient under the age of 18 years (or the age of 16 in South Australia) can have capacity to make their own healthcare decisions if they fully understand the information provided and significance of the decision being made. This is based on your clinical judgement regarding the child’s level of understanding about the decision being made. Therefore, if a patient under the age of 18 has capacity to decide, consent is not required from anyone else including their parents.  Nevertheless, from an ethical and practical perspective, a collaborative decision-making process involving a child and their parents is ideal to ensure everyone is aligned and supportive of the approach.