Decision Making and Informed Consent

Consent means giving permission. Except in rare circumstances we are not able to provide any tests, examinations, procedures or treatments without your consent.

Consent can be given in different ways. The more significant the situation/procedure the more formal the consent method needs to be. Consent can be given:

• Non verbally (unspoken)- e.g., you holding out your arm to the midwife when asked if they can check your blood pressure
• Verbally (spoken)- e.g., you or an interpreter telling us that you agree a vaginal examination
• Written- e.g., signing a consent form for a Caesarean Birth

You are able to accept (take) or decline (say no to) any care we offer. Refusing to consent or declining (saying no) a procedure will not change the rest of the care we provide you. For your consent to be valid it must be:

• Voluntary- your decision to consent or not consent is your choice alone. The decision must not be influenced (swayed) by pressure from anyone else including our staff, your birth partner, family or friends
• Informed- in order to consent you need to have all the information about what the treatment or care involves, including any risks, benefits and alternatives, and be able to use that information to make an informed decision
• Capacity- means that you are able to understand, remember and use the information that has been provided to make an informed decision ( see BRAINS below)and you are able to communicate that decision yourself or through an official translator/interpreter

If you would like to learn more about consent and your human rights, the Birth Rights website has lots of reliable information.

 

 

The BRAINS mnemonic (memory aid) is a simple way of collecting and organising information to make informed decisions about your care. These can be decisions made prior to birth for example when you are creating your birth preferences or in labour when considering consenting to a care procedure. BRAINS can be used as a formal tool with paper or as a simple checklist to make sure you have explored all of your options and have the full picture

For each decision you consider the BENEFITS and RISKS. These include the general benefits and risks as explained by our staff informed through research and clinical experience, and also those that are personal to you as an individual.

Determine if there are any ALTERNATIVE options available and the Benefits and Risks of each one.

Next consider your INTUITION, what is your gut feeling about a decision? Do you need more information/time/a second option to help you make your decision?

Is it possible to do NOTHING? What are the Benefits or Risks if you continue with your current course? Is it possible to engage in conservative management or watchful waiting? Are there any safety considerations if you defer the proposed care activity/intervention for an hour or two?

Would you like time to discuss this further or would you like a SECOND OPINION?