Consenting to medical treatment: legal requirements vs medical practice. Are healthcare providers exposing themselves to potential legal action?

AIM

This research sought to (1) clarify the law relating to consent to medical treatment; (2) assess healthcare providers' knowledge of that law; (3) determine the extent of risk of legal sanctions; and (4) make recommendations to address any knowledge gap identified.

METHOD

A questionnaire was distributed to healthcare providers in six pre-selected District Health Board areas. Participation was voluntary and open to all healthcare providers whose work requires involvement in the consent process. The Health and Disability Commissioner's Office identified 19 questions all healthcare providers are expected to know (referred to as "expected knowledge" questions). The effect that participants' clinical experience, occupation and training had on knowledge of the law was assessed. 144 questionnaires were completed.

RESULTS

Only one "expected knowledge" question was answered universally correct. Error rates for the other 18 expected knowledge questions varied between 1.4% to 75.4%. "Don't know" responses varied between 0% to 28.2%. The respondents' clinical experience and occupation had no statistically significant effect upon reported knowledge of the law. Respondents who had received training on consent issues achieved statistically significant better results than untrained respondents in respect of the expected knowledge questions, although the magnitude of difference was small. Only 51.4% of respondents had received any form of training on consent to medical treatment issues.

CONCLUSION

This research indicates poor overall knowledge of some key areas of the law relating to consent to medical treatment. Failure to redress the current knowledge levels may result in negative outcomes for patients and healthcare providers including compromised patient autonomy, poorer patient health, and potential legal liability for non-compliant healthcare providers. Improved access to the law is recommended together with legislative amendments where the law is identified as unclear.