Consent

Front 1

Health Care Consent Act (1996)

Back 1

• Describes the legislative requirements for
obtaining consent for procedures
performed by health care professionals

• Practice guidelines provide directions to
registrants of the CRTO in cases where they
believe a patient/client is incapable.

Front 2

Elements of Success

Back 2

Consent must:

1. relate to the treatment

2. be informed

3. be voluntary

4. not be obtained by misrepresentation/fraud

Front 3

Implied/Expressed Consent

Back 3

• Implied consent is determined by the
actions of the patient/client

• Expressed consent may be written or oral

• It is important to remember that consent
may be withdrawn at any time

Front 4

Informed Consent

Back 4

• Based on the concept that every person has
the right to determine what will be done to
his or her body

• Informed consent means that the
information relating to the treatment has to be received and understood by the patient/client

Front 5

Informed Consent

Consent is informed if:

Back 5

The person received information about the treatment or procedure that a reasonable person in the same circumstances would require in order to make a decision about the treatment

Front 6

Informed Consent

Consent is informed if:

Back 6

• the nature of the treatment

• the expected benefits of the treatment

• the material risks of the treatment

• the material side effects of the treatment

Front 7

Informed Consent

Consent is informed if:

Back 7

• alternative courses of action

• and the likely consequences of not having the treatment

• and the person received answers to any questions they had about the treatment

Front 8

Informed Consent

Consent NOT Required

Back 8

In any case where treatment is given without
obtaining consent, you must:
1. document your opinions with respect to capacity and all actions taken; AND
2. continue the treatment only as long as it is reasonably necessary to find a substitute decision-maker or to find a practical means to enable communication; AND

Front 9

Informed Consent

Consent NOT Required

Back 9

3. ensure that reasonable efforts are made to find a substitute decision-maker or a means of enabling communication

Front 10

Informed Consent

Consent NOT Required: Incapable

Back 10

A treatment may be administered to an
“incapable” patient/client without obtaining
consent only if:

1. there is an emergency; AND
2. the delay to obtain consent will prolong the
suffering that the patient/client is apparently
experiencing or will put the patient/client at risk
of serious bodily harm

Front 11

Informed Consent

Consent NOT Required: Apparently Capable

Back 11

A treatment may be administered to an “apparently capable” patient/client without obtaining consent only if:
1. there is an emergency; AND
2. the communication required to obtain informed consent is not possible due to a language barrier or communication disability; AND

Front 12

Informed Consent

Consent NOT Required: Apparently Capable

Back 12

3. reasonable steps have been taken to enable communication; AND
4. the delay to further means of enabling the communication will prolong the suffering that the patient/client is apparently experiencing or will put the patient /client at risk of serious bodily harm; AND

Front 13

Informed Consent

Consent NOT Required: Apparently Capable

Back 13

5. there is no reason to believe the person does not want the treatment

Front 14

Informed Consent

Consent NOT Required: Diagnostic Procedure

Back 14

An examination or diagnostic procedure may be performed without obtaining consent provided that:
1. the examination or diagnostic procedure is necessary to determine whether or not there is an emergency; AND

Front 15

Informed Consent

Consent NOT Required: Diagnostic Procedure

Back 15

2. the health care provider believes the patient/client is incapable or that there is a communication barrier that reasonable efforts have not been able to alleviate

Front 16

Informed Consent

Required when:

Back 16

Proposing a treatment or plan of treatment

• If you have any doubt that informed consent has been obtained, it is your professional
responsibility to obtain it

• you must determine your patient/client's

understanding of the ordered tests and verify
their consent

Front 17

Plan of Treatment

Back 17

• is developed by one or more health practitioners,

• provides for the administration to the person of various treatments or courses of treatment and may, in addition, provide for the withholding or withdrawal of treatment in light of the person’s current health condition.

Front 18

Plan of Treatment

Back 18

• deals with one or more of the health problems that a person has and may, in addition, deal with one or more of the health problems that the person is likely to have in the future given the person’s current health condition

Front 19

Determining Capacity

Back 19

• person is presumed to be capable unless you have reasonable grounds to believe the individual is incapable

• An individual may express wishes, while they are capable and at least 16 years old, in any written form, orally or in any other manner

Front 20

Determining Capacity

Back 20

• Expressed wishes must be followed even if the patient/client subsequently becomes incapable

Front 21

Substitute Decision Maker

Back 21

1. guardian of the person

2. attorney for personal care

3. representative appointed by the Consent and Capacity Board

4. spouse/partner

Front 22

Substitute Decision Maker

Back 22

5. child or parent of the incapable person or children's aid society or other guardian in place of a parent -- this does not include a parent who only has right of access

6. a parent with right of access only

Front 23

Substitute Decision Maker

Back 23

7. brother/sister

8. any other relative

9. the Public Guardian and Truste

Front 24

Substitute Decision Maker

Must be:

Back 24

• capable;

• at least years old, unless they are the parent of the incapable person;

• not prohibited by court order or separation agreement from having access or giving or refusing consent;

Front 25

Substitute Decision Maker

Must be:

Back 25

• available; and

• willing to accept responsibility

Front 26

Substitute Decision Maker

Must also:

Back 26

• believe that no other person from a higher
priority of substitute decision- maker exists or if they exist, that they would not object to him or her making the decision

Front 27

Substitute Decision Maker

Must also:

Back 27

• * If there is an individual who is from priority rank 1, 2, or 3 then this decision-maker MUST be the one making decisions

• act in the best interests of the incapable person

Front 28

Failure to Comply with Consent Legislation

Back 28

It is professional misconduct to do "anything
to a patient or client for a therapeutic,
preventative, palliative, diagnostic, cosmetic
or health-related purpose in a situation in
which a consent is required by law, without
such a consent"

Front 29

Professional Misconduct

Back 29

1. revocation of the registrant's certificate of registration;

2. suspension of the registrant's certificate of registration for a specified period of time;

3. imposition of terms, limitation or conditions on the registrant's certificate of registration;

Front 30

Professional Misconduct

Back 30

4. appearance before the panel for a reprimand;

5. a fine of up to $35,000