Principle Three
Obtain valid consent
Patients expect:
- To be asked for their consent to treatment before it starts
Standards & their guidance
Guidance
- 3.1.1 You must make sure you have valid consent before starting any treatment or investigation. This applies whether you are the first member of your team to see the patient or whether you are involved after other team members have already seen them. Do not assume that someone else has obtained the patient’s consent.
- 3.1.2 You should document the discussions you have with patients in the process of gaining consent. Although a signature on a form is important in verifying that a patient has given consent, it is the discussions that take place with the patient that determine whether the consent is valid.
- 3.1.3 You should find out what your patients want to know as well as what you think they need to know. Things that patients might want to know include:
- options for treatment, their risks and potential benefits;
- why you think a particular treatment is necessary and appropriate for them;
- the consequences, risks and benefits of the treatment you propose;
- the likely prognosis;
- your recommended option;
- the cost of proposed treatment;
- what might happen if the proposed treatment is not carried out; and
- whether the treatment is guaranteed, how long it is guaranteed for and any exclusions that apply.
- 3.1.4 You must check and document that patients have understood the information you have given.
- 3.1.5 Patients can withdraw their consent at any time, refuse treatment or ask for it to be stopped after it has started. You must acknowledge their right to do this and follow their wishes. You should explain the consequences or risks of not continuing the treatment and ensure that the patient knows that they are responsible for any future problems which arise as a result of not completing the treatment. You must record all this in the patient’s notes.
- 3.1.6 You must obtain written consent where treatment involves conscious sedation or general anaesthetic.
Guidance
- 3.2.1 You must provide patients with sufficient information and give them a reasonable amount of time to consider that information in order to make a decision.
- 3.2.2 You must tailor the way you obtain consent to each patient’s needs. You should help them to make informed decisions about their care by giving them information in a format they can easily understand.
- 3.2.3 When obtaining consent, you should encourage patients who have communication difficulties to have a friend, relative or carer with them to help them ask questions or understand your answers.
- 3.2.4 You must always consider whether patients are able to make decisions about their care themselves, and avoid making assumptions about a patient’s ability to give consent. This is a complex area and you should refer to the appropriate legislation. You can find further information on our website or you can contact your defence organisation for further advice.
- 3.2.5 You must check and document that patients have understood the information you have given them.
Guidance
- 3.3.1 Giving and obtaining consent is a process, not a one-off event. It should be part of on-going communication between patients and all members of the dental team involved in their care. You should keep patients informed about the progress of their care.
- 3.3.2 When carrying out an on-going course of treatment, you must make sure you have specific consent for what you are going to do during that appointment.
- 3.3.3 You must tailor the way you confirm ongoing consent to each patient’s needs and check that patients have understood the information you have given them.
- 3.3.4 You must document the discussions you have with patients in the process of confirming their ongoing consent.
- 3.3.5 If you think that you need to change a patient’s agreed treatment or the estimated cost, you must obtain your patient’s consent to the changes and document that you have done so.
Learning Material & case studies
Case Studies for principle 3
Frequently Asked Questions