What is Consent?
Consent is the giving of permission or agreement for an intervention, receipt or use of a service or participation in research following a process of communication about the proposed intervention.
Why is Consent important?
Consent must be obtained before starting treatment or investigation, or providing personal or social care for a service user or involving a service user in teaching and research (all defined as ‘interventions’ for the purpose of this policy). This requirement is consistent with fundamental ethical principles, with good practice in communication and decision-making and with national health and social care policy. The need for consent is also recognised in Irish and international law.
Other than in exceptional circumstances, it is important to note that treating service users without their consent is a violation of their legal and constitutional rights and may result in civil or criminal proceedings being taken by the patient. Such exceptional circumstances relate primarily to emergency situations where it is necessary to intervene in the absence of consent in order to preserve the service user’s life or health, or where the service user lacks capacity to give personal consent and a decision is made in his/her best interests.
What are the requirements for a valid consent?
For consent to be valid, the person must:
- Have received sufficient information in a comprehensible manner about the nature, potential risks and benefits of the proposed intervention, of any alternative intervention and of not receiving the intervention;
- Not be acting under duress; and
- Have the decision-making capacity to make the decision (even if requiring support to do so).
Therefore the person must understand that they have a choice, including the choice to:
- Give consent;
- Refuse consent;
- Withdraw consent.
Duress refers to pressures or threats improperly imposed by others such that the person believes he or she has no alternative but to consent. ‘Consent’ obtained in this manner is not valid. However, this is distinct from the limitations on choice that illness can impose on persons.
What is the aim and scope of the National Consent Policy?
The National Consent Policy provides one overarching HSE policy to guide staff. The need for consent, and the application of the general principles in this policy, extends to all interventions conducted by or on behalf of the HSE on service users in all locations. Thus, it includes social as well as healthcare interventions and applies to those receiving care and treatment in hospitals, in the community and in residential settings. How these principles are applied, such as the amount of information provided and the degree of discussion needed to obtain valid consent, will vary with the particular situation.
HSE National Consent Policy 2022 V1
A revised HSE National Consent Policy and supporting e-learning programme was launched on Monday 28th March 2022 by Dr. Colm Henry, Chief Clinical Officer, HSE. The policy has been extensively revised to take account of legislative and policy changes since 2013.
HSE National Consent Policy (PDF, size 1.1 MB, 150 pages)
E-learning programme (external link to HSEland)
This policy is applicable to all care environments where services are provided for and on behalf of the HSE including acute hospitals, the ambulance service, community hospitals, residential care settings, general practice and home care.
The policy will continue provide an important foundation to support the core principles of and enable compliance with the Assisted Decision-Making (Capacity) Act 2015 when it is commenced in June 2022.
Please bring the revised policy to the attention of all relevant staff in your area of responsibility.
A short video - What is Consent? - has been developed containing recordings of people who have used HSE services speaking about their experiences of consent in health and social care services.
Guidance regarding Cardiopulmonary Resuscitation and DNAR Decision-Making during COVID-19
Guidance has been developed for health and social care professionals (HSCP’s) in the context of the COVID-19 pandemic. It is applicable to all care environments where services are provided for and on behalf of the HSE including acute hospitals, the ambulance service, community hospitals, residential care settings, general practice and home care.
We ran a webinar series on supporting the consent process for the vaccination programme against COVID-19 in early 2021
Hall, D.E. et al (2012) Informed consent for clinical treatment
BMA Guidance - Children and Young People Ethics Toolkit
Joining the Dots - Connecting voices for child-friendly healthcare in hospital
Who can I contact for more information?
Orlaith Branagan, National Office for Human Rights and Equality Policy