Dentists need to make sure their patients are always up to speed with what is happening with their care. By doing so, they can avoid problems down the line – ensuring there are no gaps between a patient’s expectations and the reality.
All dentists are acutely aware of the importance of consent, but this post will add as a timely refresher of why it is important and how to obtain consent to avoid issues.
The importance of consent for dentists
When carrying out any form of care or treatment dentists require consent because:
- It is spelled in law that this is obtained before a dental practitioner is allowed to touch a patient
- It is needed in order to respect a patient’s right to ‘self determination’
- It makes life easier and allows you to mutually arrive at the right outcome
- Treatment is voluntary. Patients can, if they wish, withdraw from a treatment at any time and so it is vital that they are always happy with the course of action.
It is important to recognise that the Care Quality Commission will look at this. John Milne, Senior National Dental Adviser for the CQC, explained: “We review the practice’s systems and processes for obtaining consent. We may ask dental practitioners and other dental care professionals to describe how and why they ask for consent. We may look at an example of a dental care record to support what we are told.”
How to obtain consent
The consent of a patient must be ‘informed’ – that means that you must give them enough relevant information to ensure they are basing their decision on the available facts and aren’t just agreeing ‘because you told them to’.
When explaining a course of action, a dentist must:
- Explain the risks and benefits of the treatment in question in terms that could easily be understood by the patient
- Outline any possible alternative treatments and the pros and cons of these
- Explain the cost of each possible treatment
- Give the patient time to weigh up everything you have told them
- Keep a record of when and how consent is given, if necessary
Consent for dental treatment involving children
The issue of consent for treatment is complicated slightly when involving children. There are two factors here – their age and whether or not they are ‘competent’ to make a decision.
It is possible for children under the age of 16 to consent to their own treatment if they have the ‘intelligence, competence and understanding’ to be able to know what their treatment will involve. This is called being ‘Gillick competent’.
If an under-16 is not ‘Gillick competent’, then consent should be obtained from their parent or guardian.
If they are over 16 but still under 18, the patient can give consent – even though they are not an adult in the eyes of the law – and this cannot be overridden by their parents. This is a matter than can – and has been – challenged by the courts, so requires caution where there might be a dispute between both parties.
Consent and mental health
Dentists also have to bear in mind whether or not an adult has the mental capacity to give their consent.
The Mental Capacity Act 2005 sets out a two-stage process for identifying this. Firstly, this involves being aware of any conditions that might well impact on the patient’s ability to consent (eg dementia).
Secondly, you need to determine if the patient can:
- Understand the information you give to them about their treatment
- Retain and remember this information
- Come to a decision based on the information presented to them
- Adequately relay a decision to you
If you have any queries over consent, we would be happy to talk to you. Get in touch today.