Consent

Capacity to Give Consent

Under review

For the consent or refusal to be valid, the  patient must be fit to give her consent. Québec law does not define the criteria for concluding the aptitude of a person to consent to medical care; it is therefore left to the physician to determine the person’s inaptitude. The five following questions may help the physician determine the patient’s aptitude to give consent:

  • Does the person understand the condition for which the treatment is proposed?
  • Does the person understand the nature and the purpose of the treatment?
  • Does the person understand the risks involved in undergoing the treatment?
  • Does the person understand the injury he or she may incur in refusing the
    treatment?
  • Is the person’s ability to consent affected by her illness?

The physician must not neglect to assess a patient’s capacity to give consent simply because the latter consents to the proposed care. Medical interventions intruding upon the patient’s life have a particular meaning for her, and the physician must try and understand this. Knowing the patient’s history, the usual choices made and their meaning, as well as her values, will help the physician reasonably assess the validity and coherence of the consent—or refusal of these interventions. Sometimes, however, the help of a psychiatrist may be needed.

Assessing a patient’s aptitude to give consent, calls for discernment on the physician’s part. Physicians who practice in long-term care centers COLLÈGE DES MÉDECINS DU QUÉBEC, La pratique médicale en soins de longue durée : guide d’exercice, Montreal, Collège des médecins du Québec, May 2007, p. 18-20. have developed an expertise in this regard that deserves to be better known.

2011-04-04