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Obtaining consent


16 October 2015

The Dental Council Code of Practice relating to professional behaviour and ethical conduct (section 7) sets out the requirement that “informed consent” must be obtained before treatment is provided. 

But what does “informed” mean and what is meant by “consent”? How could there even be “consent” if it was not informed?

Increasing numbers of complaints and legal claims involve a failure to obtain valid consent. This is often a source of surprise and frustration to dentists who have acted in good faith when providing care. It is all too common to presume that consent has been given when there is very little to support this. 

In many cases, patients and their parents and carers do not have any real understanding of what the treatment actually entails and simply put their trust in the dentist to do the necessaries. On one level this means that the dentist can be seen as having the freedom to get on with the job.

The problem with this view however is that when a previously unexpected aspect of treatment becomes clear to the patient and / or parent / carer – for example post-operative pain, the number of appointments required, the time taken to complete treatment etc. -  it can be an unwelcome surprise. 

All of a sudden there is a question of consent; if this was not expected but it has now happened then how could the patient (or the person who consented on his/her behalf) be considered as having agreed to this?  

To avoid difficulties of this sort it is appropriate to ensure that the patient, or the party consenting on behalf of the patient, is taken through a consent “process” which includes not just the provision of information but the careful explanation of what is involved and the double-checking of the other parties understanding.

Having done this, it is also important that the dentist can demonstrate that this process took place. This is where making good, clearly detailed notes is critical.

In terms of consent the twin considerations are process and documentation.
3 comments
  • By The Web Team on 23 May 2016 10:24 Thanks for your comment, Andrea. Consent is all about communication, it’s an ongoing conversation between the clinician and the patient with the clinician finding out what the patient wants to know, as well as telling them what they need to know. Apart from treatment under GA or sedation there is no absolute requirement for written consent. What is required is evidence of the detail of discussion which has taken place, and it’s up to the individual clinician how he or she records this. Many clinicians write in the narrative of the records. Some provide the patient with a treatment plan letter if the treatment is complex or contentious and retain a signed copy of the letter in the records. There’s further information in our Consent Advice Booklet and our dentolegal advisers are always happy to guide you further. I hope this is helpful. With best wishes, Sue Boynton, Senior Dentolegal Adviser
  • By Andrea Wildsmith on 17 May 2016 02:08 verbal or written consent?
  • By Andrea Wildsmith on 17 May 2016 02:07 Can this be documented as informed consent given verbally or is written now required?
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