Consent - it's your decision

What do I need to know about consent?

• What does consent mean?
• Who can give consent?
• What if I can't give consent?
• What happens in an emergency?
• How will I be asked to give my consent?
• What information should I be given?
• How long can I take to decide?
• What if I change my mind?
• Can I refuse examination and treatment?
• What if I have a mental illness or disorder?

What does consent mean?

It means agreement. Before a doctor, nurse or any other health professional can examine or treat you, they must have your consent.

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Who can give consent?

You can give consent if you can make decisions for yourself.

• Being able to make decisions means that you can understand what is involved and can think clearly about the advantages and disadvantages of different actions.
• You must be given enough information, and you should be allowed to make up your own mind without pressure from other people.
  

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What if I can't give consent?

You can give consent only if you can understand the information you are given, make a decision and tell other people your decision. If you can't do these things, it is called 'incapacity'. In this case someone else may be able to give consent for you.

If you are an adult:

Someone can give consent for you if:

• you have given them welfare power of attorney, or 
• a court has given them a welfare guardianship order, or 
• a court has given them a welfare intervention order and the treatment is needed only for a short time.

Doctors can treat you if there is no-one who can give consent on your behalf, and the treatment will benefit you.

The section called 'How to find out more' gives details of where to get more information about the rights of adults with incapacity.

If you are under 16

• Someone with parental responsibility can give consent for you if you can't give it yourself.

The section called 'How to find out more' gives details of where to get more information about the rights of young people under 16.

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What happens in an emergency?

• In an emergency - for example, if you've been in a road accident and you need urgent treatment to save your life - you may not be well enough to make a decision about your treatment.
• If you're not able to give your consent and there is no time for anyone else to make a decision for you, doctors can treat you. But they can treat you without your consent only if this is necessary to save your life or stop you suffering more serious harm.
  

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How will I be asked to give my consent?

• You may be asked to do something to show your consent. For example, a doctor may ask to examine your foot. If you take off your shoe, it shows you agree to this.
• Sometimes you may be asked to say whether you agree to the examination or treatment.
• If the examination or treatment is complicated, for example an operation, you may be asked to sign a form showing you agree to it.
  

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What information should I be given?

• To help you make a decision, NHS staff involved in your care must give you information about the examination or treatment you are being offered in a way that you understand. You may want to know:
  • why you are being offered the examination or treatment
  • what it will involve
  • what the benefits are
  • whether there are any risks or side effects
  • how large or small the risks are
  • whether there are any alternatives
  • what may happen if you don't have the examination or treatment
  • whether you will have to pay (for example, for dental treatment), and
  • the name of the doctor who is responsible for your care.
• You have the right to ask questions if you don't understand or you want to know more. If the person who is asking you to give consent can't answer your questions, ask them if they can find out or get someone else who can help. If you think you need it, you can ask for a second opinion.
• If you need an interpreter, ask a member of staff to arrange this for you in advance. When you make an appointment, tell them which language you prefer.
• If you want, someone can be with you when you are told about the examination or treatment. This could be a friend, a relative, a partner or a carer, another member of staff, or an independent representative (often called an 'advocate').
• You may find it difficult to take in what you've been told about an examination or treatment. If you would like to take away written information to help you make a decision, you should say so.
  

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How long can I take to decide?

In emergencies, decisions will have to be made quickly. In other cases, you may be able to take more time. It is important to give you enough time to make your decision so you don't feel rushed. If you want time to think about your decision, you should say so.

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What if I change my mind?

You can change your mind about giving your consent to an examination or treatment at any time. You should tell one of the people looking after you.

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Can I refuse examination and treatment?

• Normally you can refuse an examination or treatment at any time, even if this means your health, or the health of your unborn baby, may be seriously harmed.
• It is important that you understand what may happen to you if you decide not to have the examination or treatment.
• If another treatment can be used instead, you should be given information about it. But you can't insist on a particular treatment if the NHS staff involved in your care don't think it will help you.
• Remember that you can ask for a second opinion about the treatment you have been offered.
  

Information for young people under 16

If you are under 16 and able to make decisions for yourself, you can refuse examination or treatment.

However:

• the person providing your care may ask why you don't want it. They need to know that they have given you enough information for you to come to this decision.
• in very unusual cases, where you have refused treatment and you have a very serious condition, your parents may disagree with you and want to talk things over with a lawyer.

The section called 'How to find out more' gives details of where to get more information about consent for young people under 16.

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What if I have a mental illness or disorder?

• In most cases, if you have a mental health problem, you have the same right to accept or refuse an examination or treatment as anyone else.
  
• But if you are being cared for under the Mental Health Act, you can be examined and treated for your mental illness or disorder without your consent. This will happen only if it is in your best interests. There are guidelines for certain treatments. Your doctor may need to get a second opinion from another doctor before giving you a particular treatment.
  
• The Scottish Government Health Directorates have produced a series of topic guides for people with a mental disorder and for their carers. See the 'How to find out more' section for where to get copies of these.

For more information about the rights of people with mental illnesses or disorders, see the section called 'How to find out more'.

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Page last edited: 30 July 2010