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Lessons · Medicine foundations · consent before a procedure

Consent before a procedure, as a sequence

Confirm who they are, check they can make this decision, explain what is involved, then the benefits, the risks and the alternatives including doing nothing, answer questions, ask for the decision, and record it.

Hone is a place to practise a career, one idea a day. This is one of its lessons, written out in full and free to read without an account.

What it is for

It is easy to think of consent as a signature at the end. The signature is the smallest part; the sequence is the thing, and the step everybody forgets is the alternative of doing nothing, which is always one of the options and is often the one the person most wants to ask about.

How to think about it

Learn it as an order you can run without notes, in language the person themselves used earlier in the conversation. Leave a real silence for questions rather than a rhetorical one. Then record what was discussed, not just that it was.

Worked example

Confirm the person's identity and that this is the right procedure for them
Two identifiers, before the conversation starts.
Check that they have the capacity to make this decision
About this decision, now, not in general.
Explain what the procedure involves, in words they have used themselves
Their vocabulary, not the consent form's.
Explain the benefits, the risks and the alternatives, including doing nothing
Doing nothing is always on the list.
Invite questions, and leave a silence long enough for one
A rushed invitation collects no questions.
Ask for the decision, freely made and without pressure
Freely means they can also say no, and hear no consequence in your voice.
Record the discussion and the decision, signed and dated
What was discussed, not only that something was.

Your turn

After the benefits, write the word for the other things that must be explained alongside the alternatives.

Explain the benefits, the  and the alternatives, including doing nothing.

The trap

Leaving out the option of doing nothing because it does not feel like an option. It is one, it is always available, and a conversation that never named it was not a choice between alternatives.

Practise consent before a procedure on HoneA question on it now, a coding challenge where there is one, and it is remembered for review. Free, no email needed.