Healthcare Consent legislation applies to everyone above the age of 18 (some places 16) and has the following rights (Ref 1)
1)The right to give or refuse consent
2)The right to choose a particular form of healthcare on any grounds including moral or religious grounds
3)The right to revoke consent
4)The right to expect that a decision to give, refuse or revoke consent will be respected
5) The right to be involved to the greatest degree possible in all case planning and decision making Mostly all nursing actions are an invasion of a person’s privacy and giving consent is carried out by going into the hospital or being treated at home. So one can say that consent is based on the principle of respect for a fellow human being. (Ref 1,2) This legislation tells me that all patients and clients have a right to receive information about their condition.
As a nurse I should be sensitive to their needs and respect the wishes of those who refuse or are unable to receive such information. (Ref 1,2) For instance, there may be a language barrier and I should not just go about reading the consent form in English, rather I should arrange for a interpreter or find a nurse who speaks the clients language. I also respect their decision of autonomy-their decision to accept or decline any health intervention even if a refusal means loss of life, example Jehovah s witness refusing blood transfusion. The client will now have alternate options given by the Health Care Providers. Informed consent is obtained by a legally competent person, who voluntarily accepts or declines the consent after being informed of the treatment including side effects, adverse effects.(Ref 1,2) Many people are frightened by unfamiliar medical procedures and interventions and may thus want to back off from any treatment.
This decision should be respected, and the client should not be forced into taking any of these medication or treatment. Rather the nurse can educate them to the best of her education and training if the client wants to know about it. Historically dating back to 1914, it was Justice Cardoza who changed the concept of research ethics involving human beings. The foundation of modern day informed consent is based on his statement “Every human being of adult years and sound mind has a right to determine what should be done with his (or her) own body.”(3) There were many historical events that lead to present day consent acts. Some of them were as follows (ref #3) 1) Tuskegee Study of Untreated Syphilis in Black Men (1932-1973) 2) The Nuremberg Code as a result of the Nazi Medical Experiment during World War II (1947) 3) The Thalidomide experiment that resulted in birth defects (1950) 4) The declaration of Helsinki (1964)
I feel these events all had a big role in shaping modern day HCCA and Consent legislature.Previously, a simple consent question would be “did the patient agree to surgery?” (Ref 2), which now has evolved into “Did the physician provide the patient with adequate amount of information for the patient to consent?” This newer version of the legislation allows the nurse to participate in proper advocacy so as to promote patient autonomy in self-determination. Initially informed consent meant saying “YES” to any treatment or intervention laid out by the physician and advocated by a nurse (Ref 1). Now informed consent means being able to say “NO” and this in itself is a part of exercising ones autonomy.(Ref2)Nurses should practice with the knowledge that clients must consent to be touched ,to have treatments administered , to undergo surgery, for bathing, positioning, taking vital signs, physical assessment ,changing dressings, venipuncture,wound irrigation, catheter insertion just to name a few. If a patient or client is not capable of giving consent then besides the HCCA (1996) Ontario does have the Substitute Decision Act(1992) SDA .
This act allows a substitute decision maker –a spouse, a relative, a parent and in the absence of these someone can be appointed by legal authority if the patient has not indicated otherwise. In emergencies where the priority is preservation of life, a nurse or HCP can provide care to the patient or client without their consent if they are incapacitated, provided it is demonstrated that this action was carried out in the best interest of the patient or client.(Ref 1) In conclusion, I can say that nurses are patient advocates and an essential member of the healthcare team contributing meaningfully to the informed consent process. There are many barriers to the HCCA especially in terms of informed consent, but the well informed and knowledgeable nurse is competent enough to have a thorough understanding of her clients’ needs. She being the clients best advocate will implement the informed consent procedure so as to maintain the clients’ autonomousity so that he or she can maintain their self-determination. This legislation has allowed nurses to be accountable for the best interest of the client and carry out their role as a client advocate.