Informed Care and Treatment Decisions

Central to informed consent is the principle that a competent person's informed decision should be respected. Patients should be assisted to make the best decisions they can about their health care. In order to do this they should:

• be given the information they need about:
  • their illness
  • the range of tests, treatments or research studies available
  • the purpose, benefits, risks, possible side effects and consequences of any tests, treatments or research studies
  • the identity and role of those taking care of them
  • the right to refuse a test or treatment
  • the likely consequences of refusing offered treatments
  • the right to refuse to participate in research
  • the right to withdraw consent at any time
• be given this information in clear, understandable language in an environment where open discussion is possible. If necessary, patients can request and receive assistance in order to understand and make decisions.
• be given time to think about this information before making a decision
• be involved in ongoing discussions as the case evolves
• be asked about the role they would like their family to play in matters of health-care decisions, particularly if there are concerns about them becoming incapacitated or unable to speak for themselves. They should be offered assistance in bringing these issues to the family's attention, if appropriate.

It is recognized that patients have the right to choose someone else to speak for them and make decisions should they become unable or need assistance. Similarly, a patient's right to change his or her mind about a decision, or to request a second opinion shall be respected.

There are special circumstances surrounding informed decision making, including:

• incompetent persons
• children and adolescents
• emergency situations
• delegated consent
• informing third parties
• advance directives

When dealing with these situations, the hospital staff will endeavour to respect the basic principles outlined above, while taking into account relevant legislation.

In the case of children and adolescents, both the family and the child's involvement are important in successfully caring for and treating our patients, and they both play an important role when it comes to ensuring optimal care. This involvement includes participation in any decision affecting the state of health or welfare of the patient.