The purpose of consent

English courts have confirmed the importance of consent prior to clinical interventions. Accepting that this is an essential prerequisite for lawful treatment, does consent serve any further purpose other than providing information?

Children’s doctors have a duty to take reasonable steps to put the patient (or their parent) into a position where they can make an informed decision about whether to subject themselves to the proposed treatment. Court judgements echo the tone of ‘taking consent’ (a phrase so often used by doctors), construed as an acquisition. Lord Donaldson, in Re W [1992] 4 All ER 627, viewed consent as a ‘flak jacket’, thus casting the patient as an adversary; providing the doctor with protection from the accusation of unlawful practice.

Neither construction adequately articulates the active provision of information. The notion of acquiring (‘taking’) something from the patient or parent which will protect the doctor misses the point. The primary purpose of the consent process is to provide information, to the parents or child or both. Often summarised under the headings of purpose, risks, benefits and alternatives, including the alternative of doing nothing at all.

Forming a cornerstone of modern consent law, an Australian court1 heard the case of a woman who as a 7-year-old had her right eye injured by a sharp stick. The globe was penetrated, producing a white corneal scar, overlapping her iris and blinding the eye. She sought surgery, hoping to improve her sight and …