Capacity and Consent

The Health Care Consent Act (HCCA) states consent may be implied or expressed, and a patient/client can revoke their previously expressed consent to treatment at anytime. Consent must be informed, which means that information relating to the treatment must be received and understood by the individual. (HCCA, 1996)

Treatment can occur without the individual’s consent only in specific circumstances, such as an emergency. However, reasonable steps must be taken to obtain consent prior to an emergency and no reason(s) should exist for the healthcare team to believe that the patient/client would have not wanted the treatment.

A patient, who had, in the presence of their spouse, previously stated they wished to be a full code changes their mind, and tells only the RT. The patient then arrests before the RT could express this to the healthcare team or the patient’s spouse, who verbalizes to proceed with resuscitation. How should the RT proceed?

The ethical principle involved is primarily the respect for the patient /client’s free will, which must be balanced with the need to do good and do no harm.

The RT is required to honor the patient/client’s most recently stated wishes. The patient/client’s wishes need to be articulated to the attending healthcare team and the RT should, if at all possible, refrain from participating in any resuscitation efforts. The CRTO Responsibilities under Consent Legislation PPG outlines what steps can be taken if the patient/client’s expressed wishes are contrary to the family’s and/or the healthcare team’s plan of care. Prompt and open communication with all affected parties is essential, as is clear and objective documentation.

For more information, please see the CRTO Responsibilities under Consent Legislation PPG at: www.crto.on.ca/pdf/PPG/UnderConsent.pdf