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?
In general terms, the constituent elements of a valid consent are:
- Decision-making capacity
- Disclosure of information
- Comprehension
- Voluntariness
- Agreement
In everyday health and social care practice, circumstances arise which may challenge frontline staff in seeking informed consent from service users. These may relate to, for example, carrying out an assessment of the capacity of the service user to give consent, uncertainty regarding the age at which consent may be given, what legal issues arise regarding children of unmarried or divorced parents, children of minor parents, wards of court, and so on.
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 2019 V1.3
The HSE National Consent Policy has been amended to reflect changes arising from the Health (Regulation of Termination of Pregnancy) Act 2018. The changes to the policy are as follows:
- Text added to Part 1 General Principles, Section 3.6 Consent and Pregnancy
- Text deleted in Part 1 General Principles, Section 7.7.1 Refusal of Treatment in Pregnancy
- Text added to Part 1 General Principles, Section 7.10 Refusal of Treatment in Pregnancy
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.
Please click here for further information and to access the documents.
Further information
Consent in the media
Irish Times - 24th March 2014
Irish Times, 18th August 2018
Who can I contact for more information?
Marie Tighe, Project Lead
Email: marie.tighe1@hse.ie
HSE National Quality Improvement Team, Bianconi Room, Stewarts Hospital, Palmerstown, Dublin 20
