What Is Informed Consent?

Informed consent is one of the most important tenets of quality healthcare. Based on the legal and moral concept of patient autonomy, it holds that all patients must be fully informed of the risks, benefits and alternatives to any treatment proposed by the health care team and voluntarily consent to treatment before it is instituted. Informed consent includes four related principles:

• Capacity: The patient must have the mental capacity to understand the information presented to them. This generally means that a person with advanced Alzheimer’s disease or dementia cannot give informed consent. 
• Accuracy: The medical provider must present the patient or their surrogate with complete and accurate information about the risks, benefits and alternatives to the proposed test or procedure. This includes information about the likelihood or probability that the risks and benefits discussed will occur. 
• Comprehension: The patient must understand the information presented to them. The provider is responsible for ensuring this is the case.
• Voluntary consent: The patient’s consent must be fully voluntary and free of coercion or duress. 

Included in the concept of informed consent is the right to refuse treatment, even if that refusal may result in an outcome that the average person would consider undesirable (for example, worsening disability or death). In most cases, the medical provider will try to offer other options if the patient decides to forgo their recommendations. But they can’t override a patient’s decision except in cases in which:

• The patient is a minor
• The patient is mentally incapacitated by alcohol or other mind-altering substances or has a psychiatric illness that prevents them from understanding the information presented to them
• The patient is a threat to the community (for example, they have a highly communicable disease or need psychiatric care to prevent harm to others or themselves).

The requirement for informed consent is usually waived in the event that a person is unconscious or incapacitated and there is no surrogate available if immediate treatment is needed to save their life.

Sources 

“Informed Consent”. AMA Code of Medical Ethics. https://code-medical-ethics.ama-assn.org/ethics-opinions/informed-consent