Principle 3 - Obtain Valid Consent

Question 0

Summarise Principle 3 in three points

Answer 0

• 3.1 Obtain valid consent before starting treatment, explaining all the relevant options and the possible costs
• 3.2 Make sure that patients (or their representatives) understand the decisions they are being asked to make
• 3.3 Make sure that the patient’s consent remains valid at each stage of investigation or treatment

Question 1

What is Principle 3?

Answer 1

• Obtain valid consent

Question 2

When must you gain valid consent? What can you never assume? (3.1.1)

Answer 2

• Before starting any treatment or investigation
• This applies whether you are the first member of your team to see the patient or if someone in the team has seen the patient
• Do not assume that someone else has obtained the patient’s consent

Question 3

How must you document obtaining valid consent? How important is a signature? (3.1.2)

Answer 3

• Document the discussions you have with patients in the process of gaining consent
• Although signature on a form is important, discussions that take place with the patient determine whether the consent is valid (3.1.2.)
• You must check and document that patients have understood the information you have given (3.1.4)

Question 4

Give the GDC examples of things patients might want to know when giving consent? (3.1.3) (8)

Answer 4

• Options for treatment, the risks and the potential benefits
• Why you think a particular treatment is necessary and appropriate for them
• The consequences, risks and benefits of the treatment you propose
• The likely prognosis
• Your recommended option
• The cost of the proposed treatment
• What might happen if the proposed treatment is not carried out; and
• Whether the treatment is guaranteed, how long it is guaranteed for and any exclusions that apply

Question 5

What must you check and document? (3.1.4)

Answer 5

• You must check and document that patients have understood the information you have given

Question 6

When and why can patients withdraw consent? What should you do if this happens? (3.1.5)

Answer 6

• Patients can withdraw their consent at any time, refuse treatment or ask for it to be stopped after it has started.
• You must acknowledge their right to do this and follow their wishes
• You should explain the consequences or risks of not continuing the treatment and ensure that the patient knows that they are responsible for any future problems which arise as a result of not completing the treatment
• You must record all this in the patient’s notes

Question 7

When must you obtain written consent? (3.1.6)

Answer 7

• You must obtain written consent where treatment involves conscious sedation or general anaesthetic

Question 8

How must you ensure that patients (or their representatives) understand the decisions they are being asked to make? (3.2)

Answer 8

You must:

• Provide patient with sufficient information and a reasonable amount of time to consider that information (in order to make a decision) (3.2.1)
• Tailor the way you obtain consent to each patient’s needs. Help them make informed decisions about their care by giving them information in a format they can easily understand (3.2.2)
• When obtaining consent, encourage pts who have communication difficulties to have a friend, relative or carer with them to help them ask questions or understand your answers (3.2.3)

Question 9

What must you consider and what must you avoid when gaining consent? What should you refer to? (3.2.5)

Answer 9

You must: (3.2.4)

• Consider whether aptients are able to make decisions about their care themselves
• Avoid making assumptions about patient’s ability to give consent
• This is a complex area - refer to the appropriate legislation.

Question 10

What must you do at the end of the consent discussion? (3.2.5)

Answer 10

• Check and document that patients have understood the information you have given to them

Question 11

What must you do at each stage of treatment or investigation? (3.3)

Answer 11

• you must make sure that the patient’s consent remains valid at each stage of investigation or treatment

Question 12

How is giving and obtaining consent a process? How should it be addressed? (3.3.1)

Answer 12

• Is a process not a one off event
• Should be part of on-going communication between patients and all members of the dental team involved in their care
• You should keep the patinets informed about the progress of their care

Question 13

What must occur when carrying out an on-going course of treatment? (3.3.2)

Answer 13

• You must make sure you have specific consent for what you are going to do during that appointment

Question 14

How must you confirm ongoing consent? (3.3.3)

Answer 14

• You must tailor the way you confirm ongoing consent to each patient’s needs and check that patients have understood the information you have given them

Question 15

What must you document? (3.3.4)

Answer 15

• You must document the discussions you have with patients in the process of confirming their ongoing consent

Question 16

What must you obtain if you think you need to change a patient’s agreed treatment or estimated cost? (3.3.5)

Answer 16

• You must obtain your patient;s consent to the changes and document that you have done so