INFORMED CONSENT IN ONTARIO

Physicians are required to obtain the informed consent of the patient or a substitute decision maker before proceeding with investigation or treatment.

IN EMERGENCY SITUATIONS
In situations involving immediate risk to life and limb and a valid consent is not possible from the patient or substitute decision maker, the physician must act in the best interests of the patient and proceed with investigation and treatment as required. Advance directives or “living wills” (a document stating how one wishes to be treated in the event of illness) are now commonplace and should be adhered to as well as possible.

PRINCIPLES OF A VALID CONSENT:
The physician should provide the patient the necessary information in understandable language to make an informed choice. The principle of autonomy or self-determination should form the basis of your approach.

1. The patient must be “capable”: The patient must understand and appreciate the consequences of a decision.
   
   
2. The physician must disclose the relevant information: The patient should learn of the nature of the investigation(s) or treatment(s) proposed, their risks and benefits, other important possible approaches and the likely consequences of refusing investigation or treatment.
   
   
3. The patient should understand: The physician should ensure that the patient has not misinterpreted the information.
   
   
4. Consent must be voluntary: The individual must not be manipulated or coerced into choosing a given option.
   

AGE OF CONSENT
There is no minimum age of consent In Ontario or Canada. The above principles of a valid consent apply. The maturity and understanding of the child and not the age is considered the important factor. Prudent physicians will involve parents in decision making, especially for those patients less than 16 years of age.

WRITTEN CONSENT
Consent does not necessarily need to be in writing. A written consent, however, is prudent for important health care decisions. Consent is all about good communication.