Consent

1. consent

2. • Free and voluntary agreement
• Approval or permission for compliance of some act
• Valid only after knowing the nature and consequence of
the consent.

3. TYPES OF CONSENT
• IMPLIED CONSENT
• EXPRESSED CONSENT
• INFORMED CONSENT

4. IMPLIED CONSENT
• For medical examination
• No need for a separate written or oral consent

5. EXPRESSED CONSENT
• EXPRESSED BY WRITTEN OR VERBAL

6. INFORMED CONSENT
• Consent is giving after knowing and the understanding
RESULT , NATURE, QUALITY OF ALL THE POSSIBLE RISKS,
Involved in a procedure as well as having alternate choice.
• The purpose of informed consent is to give patient the sufficient
information.
• It should be a written consent.

7. • SEC. 87 AND 88 IPC
• SEC. 89 IPC
• RULES OF DISCLOSURE

8. RULES OF CONCENT
1. Consent should be free and voluntary and there should not be any under
influence, fraud, misrepresentation.
2. Should be in a proper form (drafted)
3. Written consent should be witnessed by another person
4. Doctor should explain all the object of examination, and informed them
that these are recorded in medical repot.

9. 5. if the inmate in a hostel is less than 12 yrs , consent should be obtain from
the warden
6. Nature of illness of the patient is not revealed to the warden unless
consent. ( exception : communicable disease ).
7. Consent is not a defence in case of professional negligence.
8. For artificial insemination, contraceptive sterilization ,etc the consent
should taken from both partners.

10. 9. In prenatal diagnosis procedures, informed we=ritten consent should be
taken from the pregnant women.
10.For an operation or treatment consent from the spouse is not needed.
11.In a multistage treatment , each stage should taken the consent.
12.A patient cannot be detained in a hospital against their will. the matter
should be recorded and allow to leave.
13.For donating the organs, should take the consent from partner or next of
kin

11. 14. For pathological autopsy consent should taken from the relatives
15. For medicolegal autopsy no consent is needed from the relatives
16. For massive immunization programs by the government no consent is needed.*
17. Doctor can give new life saving drug with consent
18. For MTP, the consent is valid 18 yrs or more aged old lady’s consent alone.
19. Sexual intercourse with a women below 18 old even with her consent taken as
Rape.

12. 20.Sec 53 Cr IPC
21.In criminal case consent is not take as a defence
22.Examination of a victim of a criminal case consent is mandatory.
23.Below 18 or mentally ill person cant give consent, so parents will give the
consent.

13. EXCEPTION
• SEC 92 IPC
• THERAPEUTIC PRIVILAGE
• THERAPEUTIC WAIVER
• SEC 53 CR IPC
• SEC 174 CR IPC
• FOR NOTIFIABLE DISEASE TREATMENT
• PSYCHIATRIC EXAMINATION ORDERED BY COURT

14. INFORMED REFUSAL
• Informed refusal is where a person has refused a recommended
medical treatment based upon an understanding of the facts and
implications of not following the treatment.
• fundamental ethical and legal doctrine that protects the patient's
rights of personal autonomy and bodily self-determination
• An adjunct to the doctrine of informed consent advanced by some
is the notion of informed refusal.

15. • The physician then needs to explain the risks of not following
through with the recommendations to allow the patient to make an
informed decision against the recommendation.
• When refusal of treatment may result in significant damage or
death, the interaction needs to be documented to protect the care
giver in a potential later litigation against the allegation that the
recommendation was either not made or not understood.

16. • On occasion, a patient will also refuse to sign the "informed refusal"
document, in which case a witness would have to sign that the
informed process and the refusal took place.

17. • COMMUNICATION
As a healthcare provider, effective communication and thorough patient
education are your best allies for encouraging patient collaboration and gaining
patient cooperation in selecting and adhering to a treatment plan.
• However, patients can refuse care even if the consequences might be dire.

18. REFUSAL FORM
• • The patient’s diagnosis
• • Treatment options and the treatment plan the patient elected (if any), as
well as risks and benefits associated with each.
• • Acknowledgement that the patient refused or terminated treatment

19. • • Specific risks that might occur if the patient doesn’t receive care, and
acceptance of the risk on the part of the patient
• • The patient’s signature (if he/she agrees to sign).