Dialogue Volume 11 Issue 2 2015 | Page 39

Consent to treatment Consent is not simply a signed piece of paper photo: istockphoto.com/RapidEye T he College’s recently approved Consent to Treatment policy makes it clear that obtaining consent to treatment involves a dialogue between the physician and the patient (or the substitute decision-maker). For consent to be informed, the physician must share information about the treatment that is needed in order to make a decision. Consent is not just a signature on a form, it is obtained through dialogue, said Dr. Dennis Pitt, a general surgeon from Ottawa, and chair of the policy working group. The policy emphasizes that “A physician should not physicians must obtain valid be lulled into the false consent before treatment is provided. In order for consent security of a signed to be valid it must: consent form. It is •  obtained from the be not a substitute for a patient if they are capable with respect to the treatdialogue” ment or from the incapable patient’s substitute decision-maker; • be related to the treatment, • be informed; • be given voluntarily, and •  ot be obtained through misrepresentan tion or fraud. Patients or an incapable patient’s substitute decision-maker must be provided information about the treatment so that they can make an informed decision. To this end, physicians must provide sufficient information to facilitate the decision-making process and this includes, but is not limited to, information about the expected benefits, material risks and side effects, and alternative treatment options. Physicians are required to have a dialogue with the patient or substitute decision-maker about this information even if they use supporting documents, including consent forms. “A physician should not be lulled into the false security of a signed consent form. It is not a substitute for a dialogue,” said Dr. Pitt. If the patient or incapable patient’s substitute decision-maker is not provided with sufficient information to reasonably make a decision, and in a form that they can understand, their consent may not be valid. Because information only facilitates decision-making if the information is provided, reviewed and understood prior to giving or refusing consent to a treatment, the policy states that “physiIssue 2, 2015 Dialogue 39