Consent for Treatment
Health care professionals must continually communicate with patients and patients must continue to willingly consent to their care. Without this, there is no informed consent. Informed consent must be ongoing.
Consent should be obtained from clients or substitute decision-makers whenever dietitians are recommending a nutritional therapy (e.g. therapeutic diet, tube feeding or TPN). While a signed consent form from a client may be desirable, it is not necessary. What really matters is that there is evidence that a client was given the necessary information and provided consent. Simply recording the fact that consent was obtained after a discussion with a client, and it appeared to the dietitian that the consent was genuine and informed, is often sufficient. Both a signed consent form and a dietitian's note in a chart documenting consent are legally recognized ways of demonstrating that actual consent was obtained. Dietitians should also consult organizational policies to determine if there are any facility protocols for documenting consent.
The role of the practitioner is to provide information and make recommendations that will enable clients to make informed decisions. A dietitian must be sensitive to and respect any wishes from a client to withdraw consent. However, withdrawal of consent should be informed. The client should reasonably understand the foreseeable consequence and risks to withdrawing consent and be informed of alternatives to the proposed treatment.
PHIA addresses consent for the collection, use and disclosure of personal health information in Nova Scotia.
References: The College of Dietitians of Ontario (2015). The Jurisprudence Handbook for Dietitians in Ontario (pg. 75) and The Nova Scotia College of Medical Laboratory Technologists (2016). Professional Practice for Medical Laboratory Technologists in Nova Scotia.