FM10.19 | Consent in Medical Practice — Summary & Reflection

KEY TAKEAWAYS

Consent requires four attributes: voluntary, informed, capacity, and specificity. Performing a procedure without valid consent constitutes battery (Samira Kohli 2008). Types of consent range from implied (routine acts inferred from conduct) to oral expressed to written expressed to informed consent (the highest standard — disclosure of nature, purpose, material risks, alternatives, and consequences of refusal). Informed consent requires seven ingredients including disclosure of all material risks assessed from the patient's perspective. Age rule: 18 years is the age of majority; guardian consent is required for minors, EXCEPT under the MTP Act 2021 (minor does not need parental consent for termination). Emergency doctrine of necessity: proceed without consent only when patient lacks capacity, situation is immediately life-threatening, and no substitute decision-maker is available. Mental Healthcare Act 2017: psychiatric diagnosis alone does not negate capacity; assess formally. Capacity is lost during severe alcohol intoxication; defer elective procedures. Document consent specifically, before premedication, and witnessed.

REFLECT

Think about the last time you observed a consent process being obtained in a clinical setting — ward round, outpatient clinic, or pre-operative bay. Was the consent truly informed? Were material risks disclosed? Did the patient have a genuine opportunity to ask questions? Was the form signed before any premedication? Reflect on what the gap between the legal standard of informed consent and everyday clinical practice looks like in your institution, and what you would do differently as the responsible clinician.