Informed consent

Informed consent is a central ethical and legal principle in the provision of health care, including nursing care; it applies to all health interventions with certain well-defined exceptions (such as life-threatening situations).[34] The requirement for consent to be informed is justified on the ethical grounds of avoiding harm, unfairness and exploitation, as well as of protecting a person’s autonomy or self-determination.[35]

The requirements of informed consent include: disclosure (of all the relevant information), comprehension (the person must understand the information being given and the implications of consent), competence (the person must be capable of making the decision), and consent must be freely given (voluntary).[36]  Informed refusal can also be the outcome of the process.
For example, it is a legal requirement before undertaking HIV testing that a person has provided informed consent (with rare exceptions such as where a legal order is made for compulsory testing or in emergencies).[37] This means that the person agrees to testing on the basis of understanding the procedure, the reasons for testing and is capable of evaluating the personal implications of testing.[38]  In cases where routine HIV testing is recommended (such as in pregnant women), informed consent should still be obtained. Breaches of the requirement to obtain informed consent can have serious consequences, including harm to patients and legal repercussions for the health worker.[39]

Ethical nursing care ensures each person is responded to as a unique individual and assisted to participate in informed decisions about his or her care (including refusing treatment or care) without being disadvantaged due to appearance, language, culture, religion, age, sexuality, economic status, disability or health status.  This approach ensures respect for the client’s autonomy and upholds his or her right to informed consent.