CONSENT TO MEDICAL AND SURGICAL PROCEDURE

Consent is defined as a “free and rational act that presupposes knowledge of the thing to
which consent is being given by a person who is legally capable to give consent”

Nature of consent- an authorization by the patient or a person authorized by the law to

give the consent on the patient’s behalf.

Informed Consent-A written consent should be signed to show that the procedure is the
one consented to and that the person understands the nature of the procedure

The nurse’s responsibility in witnessing the giving of informed consent involves:

(1) witnessing the exchange b/w the client and the physician
(2) witnessing the client affix his signature
(3) establishing that the client really understood.

ESSENTIAL ELEMENTS OF INFORMED CONSENT:

1. The diagnosis and explanation of the condition
2. A fair explanation of the procedures to be done and used and the consequences
3. A description of alternative treatments or procedures
4. A description of the benefits to be expected
5. Material rights if any
6. The prognosis, the recommended care, procedure is refused

WHO MUST CONSENT?

Patient must consent in his own behalf. If he is incompetent, or physically unable, and is not
in emergency case, consent must be taken from another who is authorized to give it in his
own behalf.

CONSENT OF MINORS
Parents or someone standing in their behalf, gives the consent to medical or surgical
treatment of a minor. Parental consent is not needed if the patient is married or
emancipated.

CONSENT OF MENTALY ILL

A mentally incompetent person cannot legally consent to medical or surgical treatment. The
consent must be taken from parents or legal guardian.

MENTAL COMPETENCY
All patients are presumed to be competent unless declared incompetent by a court of law.
Supporting documentation of the patient’s behaviors, speech, decision making and physical
and mental status are very useful in establishing his/her mental competency

EMERGENCY SITUATION
No consent is necessary because inaction at such time may cause greater injury. If time is
available and an informed consent is possible, it is best that this be taken to protect all the
parties concerned.
REFUSAL TO CONSENT
A patient who is mentally and legally competent has the right to refuse the touching of his
body or to submit to a medical or surgical procedure no matter how necessary, nor how
imminent the danger to his life or health if he fails to submit to treatment.

CONFIDENTIALITY

(From The Latin confidere “to trust”)

Confidentiality refers to the medical or professional secrecy in which certain information is

committed to a nurse or physician in an official capacity for the sake of medical assistance.

This is in conjunction with one provision of the Hippocratic Oath: “Whatever I see or hear,
professionally or privately, which ought not to be divulged, I will keep secret and tell no
one.”

The practical function of confidentiality in a nurse-patient relationship underscores the

confidence and trust that the patient has for a physician. With this feeling of confidence, the
patient is not reluctant but cooperative in giving personal information to the nurse.

It is argued, however, that confidentiality is not absolute. Under certain conditions, it is

better to violate it than to preserve it. Confidentiality can be violated if it is necessary to
produce conditions which will bring about happiness and well-being.

Four conditions may be cited to justify the violation of confidentiality

1) when keeping the secret would be detrimental to the common good.
2) when the subject of secret intends to inflict grave injury upon an innocent third party.
3) when it is necessary for the subject of the secret to avert grave injury.
4) when it is necessary for the one keeping the secret to avoid grave injury

Patient Responsibilities
1. Patients, and their families when appropriate, are responsible for providing correct and
complete information about present complaints, past illnesses, hospitalizations,
medications, and other matters relating to their health.
2. Patients and their families are responsible for reporting unexpected changes in their
condition or concerns about their care to the doctor or nurse taking care of them.
3. Patients and their families are responsible for asking questions when they do not
understand their care, treatment, and service or what they are expected to do.
4. Patients and their families are responsible for following the care, treatment, and service
plans that have been developed by the healthcare team and agreed to by the patient.
5. Patients and their families are responsible for the outcomes if they do not follow the care,
treatment, and service plan.
6. Patients and their families are responsible for following the hospital’s rules and
regulations.
7. Patients and their families are responsible for being considerate of the hospital’s staff
and property, as well as other patients and their property.
8. Patients and their families are responsible to promptly meet any financial obligation
agreed to with the hospital.