#3 Consent Series: What is informed consent for health care?

Shifting the focus from ‘we know best’ to self-determination

In BC, consent for health care is governed by the Health Care Consent and Care Facility Admission Act. This law sets out the rules for how a health care provider must get consent before providing health care to an adult (someone 19 years or older).

Informed consent is about having the information you need in order to make a decision that fits for you. Your decision must be voluntary. You must not be pressured or deliberately given misinformation.

The law says a health care provider must give you information about:

• What condition the health care is for (your diagnosis or possible diagnosis);
• What health care they want to give you (the proposed treatment, test or other intervention);
• How it may help you (the benefits);
• How it may harm you (the risks); and
• Other health care you could choose instead (possible alternatives).

The health care provider must also allow you to ask questions and get answers.

If you give consent, you can change your mind and revoke (withdraw) your consent. When you give consent, it applies to the proposed health care only; every new treatment requires consent.

When you consult with a health care provider (doctor, dentist, occupational therapist or others – see #2 Consent Series) the process of informed consent most often involves a short and simple discussion. The amount of time will depend on the nature of the diagnosis and the amount of risk or side effects. In some cases, you might decide to consult a second opinion.

The law recognizes that health care decisions are not only based on ‘medical’ information; you will also decide based on your values and beliefs – what is important to you for your quality of life.

What happens if you are not capable of giving or refusing consent? You can make a Representation Agreement to appoint someone who can make health and personal care decisions on your behalf. If you are incapable of informed consent, the health care provider must provide information to your representative, just as they would if they were getting consent from you. Your representative must make decisions according to your wishes, values and beliefs – what is important to you.

Self-determination is one of the key principles underlying the Health Care Consent and Care Facility Admission Act and the Representation Agreement Act. These laws are the result of a community-government partnership designed to shift the health care system from a paternalistic ‘we know best’ approach to one that is based on a person’s wishes and values.

We will discuss the law reform in future Ask Joanne posts as well as consent in emergency situations. Stay tuned!

 

Read the previous Ask Joanne posts in the Consent Series:

#1 Do I have the right to refuse health care? Can someone refuse health care on my behalf if I am not capable?

#2 Does health care consent only happen in the hospital?

 

To learn more about what happens if you are incapable of giving or refusing consent, read:

Fact Sheet: Health Care Consent: How Decisions are Made if you are Incapable

To learn more about appointing a representative in a Representation Agreement:

John and Mary Plan for Health and Personal Care