Informed Consent in Medical Care

Informed consent is a patient’s voluntary agreement to medical treatment after receiving and understanding the information needed to make a choice. It is an ongoing process of communication, not merely a signature on a form, and protects the patient’s bodily autonomy and dignity.

Essential requirements

Consent is valid only when the patient has decision-making capacity, receives adequate information in understandable language, and decides without coercion, deception or undue influence.

• Disclosure should cover the nature and purpose of the treatment, expected benefits, substantial risks, reasonable alternatives and likely consequences of refusing it.
• Consent must be specific to the proposed intervention; permission for examination or diagnosis does not automatically authorise an unrelated treatment or surgery.
• The patient should have an opportunity to ask questions and may refuse or withdraw consent after being informed of the consequences.

Forms and practical application

Consent may be implied for routine, non-invasive examination, but significant or invasive interventions ordinarily require express consent. The professional ethics code requires written consent before an operation.

• Information must be adapted to the patient’s language, comprehension and circumstances rather than delivered as technical terminology.
• For a minor or a person unable to decide, consent is generally obtained from a parent, guardian or legally authorised representative, while involving the patient as far as possible.
• A blanket consent form does not replace meaningful disclosure and voluntary decision-making.

Legal basis and limited exceptions

The principle follows from personal liberty and autonomy under Article 21. In Samira Kohli v. Dr. Prabha Manchanda (2008), the Supreme Court held that a competent adult’s voluntary and adequately informed consent is required before treatment.

• In an emergency, necessary treatment may proceed without prior consent when the patient cannot consent and delay would endanger life or health.
• If time permits, the clinician should seek consent from an available authorised representative and document the circumstances.
• Consent does not excuse negligent treatment or authorise an unlawful act.