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Consent means an agreement, compliance or

permission given voluntarily without any


compulsion. Section 13 of The I ndian
Contract Act states that 'two or more persons
are said to consent when they agree upon the
same thing in the same sense'.
Common meaning of consent is permission
whereas the law perceives it as a contract i.e.
an agreement enforceable by law.

In consent there are four separate but correlated elements that
are:
Capacity: Degree of ability of the patient to understand the
nature and consequences of the treatment offered.
Decision-making: The ability to take decisions regarding
consent.
Knowledge: Sufficient amount of information about the
nature and consequence of the treatment has been disclosed
to the patient.
Voluntary: Willingness of patient to undergo treatment. .

To be legally valid all these elements must be present in the
consent.

Age
Soundness of mind
Ability to understand
Remember the information given
Ability to deliberate and decide the treatment
choices
Believes that the information applies to the
said patient and specific purpose

TYPES OF
CONSENT
GENERAL
CONSENT
INFORMED
CONSENT
SURROGATE
CONSENT
Definition: The process in which
patient is informed about the routine
medical and nursing care that will be
provided to the patient based on
which he takes decision of getting
registered and admitted in the
hospital.


Clinical consultation.
Admission.
Disclosure of information required for
clinical management (confidentially).
Routine medical examination (physical
examination, palpitation, percussion,
auscultation).
Routine lab and imaging investigations.
General nursing care.
Diet and Physiotherapy assessment and
counselling.

Definition: It is a process in which
the physician provides adequate
information for the patient or
patient's legal representative to
make an informed decision on the
proposed treatment, including
medications or procedure.


Mental capacity of the patient to enter into a
contract (This also includes his ability to
understand information given).
Complete Information to be provided by
doctor.
Voluntary acceptance of the procedure by the
patient.
Should be person and procedure specific.


Condition (Disease) of the patient.
Purpose and nature of intervention*.
Benefits of the intervention.
Risks involved.
Alternatives available.
Prognosis in the absence of intervention.
Immediate and future cost.
*The knowledge regarding the intervention should be in an
understandable language and format so that decision in the form of
authorization by patient can be made.
Definition - This consent is given by
family members for minors or dead.
Generally, courts have held that
consent of family members with the
written approval of 2 physicians
sufficiently protects a patients
interest.
Informed consent obtained after
explaining all possible risks and
side effects is superior to all
other forms of consent and
legally defensive.

Simple medical examination the minimum age of consent is 12
years.
For consenting to have any major diagnostic or therapeutic
procedure or surgery the age is above 18 years (I.P.C. Sections
87-93).
The patient should be mentally sound and he/she should not be
under any fear or threat or any false conception.
The patient should not be intoxicated or sedated.
Incomplete information about the patients diagnosis,
therapeutic plan etc. is a commission than misconception of
omission.
When a person is incapable of giving consent a substituted
consent can be taken from the next of kin. Generally accepted
order is spouse, adult child, parents, siblings, and lawful
guardian.


Donation & Transfusion of Blood & Blood
Products.
Administration of Sedation.
Administration of Anesthesia and/or Narcotic
analgesia.
All Invasive, Surgical and High Risk Procedures
/Treatment.
Research Activity.
Endoscopy (e.g., bronchoscopy, colonoscopy,
cystoscopy, laparoscopy);





Require injections of any substance into a joint space or
body cavity, including any nonvascular space.
For HIV testing.
Aspiration of body fluids through the skin (e.g.,
arthrocentesis, bone marrow aspiration, lumbar
puncture, paracentesis, thoracentesis).
Biopsy (e.g., breast, liver, muscle, kidney,
genitourinary, prostate, bladder, skin).
Central vascular access device insertion (e.g.,
arterial line, Swan-Ganz catheter, percutaneous
intravascular catheter (PIC) line, Hickman catheter)





53(1) Cr PC: In criminal cases when examination of an arrested person
can lead to vital evidence related with the commission of crime, he can
be examined by the doctor without his consent and even using force, if
the application for examination is from a person not below the rank of
sub Inspector.
Section 54 Cr PC: An arrested person can also request to be examined
by a doctor to detect any evidence which he feels is good for him.
Section 87 IPC: A person above 18 yrs of age can give consent to
suffer any harm if the act is not intended and not known to cause death
or grievous hurt.
Section 89 IPC: A child under 12 yrs of age or a person of unsound
mind cannot give consent to suffer any harm for an act which may
cause grievous hurt or death even if done in good faith , but the consent
has to be obtained from the guardian of the child or insane person.

Section 90 IPC: Consent given by an insane person or given under
fear of injury, death etc. or due to misconception of a fact is invalid.

Section 92 IPC: Any harm caused to a person in good faith even
without the persons consent is not an offence if the circumstances
were such that it was impossible to obtain consent of the person or
his lawful guardian at that material time for that thing to be done for
the benefit of the person.
However the act should not extend to intentionally causing hurt
other than for preventing death, grievous hurt or curing of disease or
infirmity.
Consent of both spouse required in case of sterilisation and Artificial
insemination.

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