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HSE Consent Policy

Everyone has the right to make decisions about their own treatment and care.

Healthcare workers must ask for consent for all health and social care interventions.

HSE National Consent Policy

About the policy

The policy describes how every person has the right to be involved in decisions about their treatment and care.

A person must give their consent before any type of medical procedure, test, or examination.

Consent should be sought throughout the course of care and treatment, and not treated as a single event.

Each person should be supported to make their own decisions wherever possible.

The policy provides guidance on:

  • defining consent
  • supporting a person to make a decision
  • capacity to consent
  • refusing consent or when someone changes their mind
  • emergency situations
  • documenting consent
  • Assisted Decision-Making (Capacity) Act 2015

Who does the policy apply to?

All healthcare workers must follow the HSE National Consent Policy.

Consent is required for all treatment. The healthcare worker providing the treatment must ensure that the person has given a valid consent.

Healthcare workers must ask for consent before a person:

  • has a test or treatment
  • uses a health or social care service
  • takes part in research or teaching
  • uses a remote service such as online or over the phone

Consent must be asked from from people in:

  • hospital
  • community
  • day, residential and respite services

What is consent in healthcare?

Every adult is presumed to have capacity to decide for themselves even if they need support to do so.

For consent to be valid, the person must:

  • make a voluntary choice
  • be given information that they can understand
  • have the capacity to give consent (even if they need support to do so)

Consent given voluntarily

Consent must be given voluntarily. The healthcare worker should ensure that the person understands their right to say yes or no to treatment and make a decision without feeling pressured.

The person should understand they have the option to:

  • give consent
  • refuse consent
  • withdraw consent

Easy-to-understand information

The person must be able to understand the information provided and use it to make an informed decision.

The person must be given full information about what the treatment involves. This includes possible benefits and risks of the treatment, if there are other treatment options and what might happen if the treatment does not proceed.

The healthcare worker must give information in a way the person can understand and use to make an informed decision, for example, easy-to-read, plain English, pictures, diagrams or videos.

Capacity to make an informed decision

Capacity means being able to:

  • understand the information
  • use and weigh that information to make a decision
  • communicate that decision

The policy describes how a person may still get the treatment they need if they lack capacity to consent.

Getting consent

The person can give or refuse consent in different ways.

This includes:

  • speaking
  • writing
  • nodding their head, or other gestures such as raising their hand to say stop
  • using a communication device
  • by implication (such as raising their hand to say stop, holding their arm out for a blood pressure reading)

The person has the right to change their mind before the procedure and withdraw their consent provided there is no valid and applicable advance healthcare directive to the contrary.

If a person is scheduled for a major procedure, such as an operation, consent should be sought well in advance so that the person has time to understand the procedure and ask questions.

Documenting consent

Seeking consent is never just getting a consent form signed. A signed consent form is only one means of documenting that a communication process took place.

Healthcare workers must document:

  • what was explained, discussed and agreed with the person
  • how consent was given

If different healthcare workers will be providing different aspects of care, they should each document their role in the consent discussion.

Children and young people

The policy uses the word ‘child’ for someone under 16 years of age and ‘young person’ for someone aged 16 or 17.

A young person aged 16 or 17 can to consent to their own treatment. If a young person does not have the capacity to consent, their parents may give consent (until the young person reaches the age of 18 years).

Parents and legal guardians have the right to give consent for their child under 16.

Emergency situations

The policy advises that in an emergency there may not be time to get consent.

In an emergency, a healthcare worker can provide treatment with no consent to:

  • save the person’s life
  • prevent significant harm, injury or serious deterioration of the person’s condition

Training

Consent Policy in an easy-to-read version

HSE National Consent Policy easy-to-read version (PDF, 6.7 MB, 31 pages)

Consent Policy e-learning

Healthcare workers providing services for the HSE should complete the HSE National Consent Policy 2022 e-learning programme. The programme uses patient stories and decision-making scenarios to assess the user's ability to apply the policy in real-life situations.

HSE National Consent Policy 2022 e-learning programme on HSeLanD

Consent policy webinars

HSE National Consent Policy learning event 22 January 24 (video)

HSE National Consent Policy 2022 Updates - new templates, appendices 6, 7, 8, and Q&A 29 January 2024 (video)

Key moments in this video:

  • From 27:50 - Is it possible to proceed with an intervention if the person’s preferences are known as wishing to proceed, but it is recognised that they do not understand the risks involved?
  • From 30:00 - People with intellectual disabilities continue to face barriers such as consultants requesting consent forms from 'next of kin' before going ahead with procedures.
  • From 47:23 - Clarification on ‘will and preference’, ‘best interests’, ‘benefit to the patient’ and ‘doctrine of necessity’.

Related content

Assisted Decision Making Capacity Act (2015)

Assisted Decision Making Capacity Act (2015) training

Do Not Attempt – CPR (DNA-CPR)

Contact

Email: National.consentpolicy@hse.ie