INSURANCE
Your guide to obtaining informed consent
Informed consent is a fundamental part of safe and ethical aesthetic practice.
Failing to obtain proper consent can compromise patient care and expose practitioners to legal and reputational risks. A well-documented consent process ensures that patients fully understand the proposed treatment, including its benefits, risks, and alternatives, before making an informed decision.
As part of our commitment to supporting practitioners, Cosmetic Insure has partnered with Kennedys, a global law firm and leading expert in insurance claims, to address a recurring issue in malpractice cases – the improper or insufficient obtaining of informed consent. This can significantly impact a practitioner’s ability to defend against claims.
To help mitigate these risks, we have developed a comprehensive guide on best practices for obtaining informed consent. This resource is designed to enhance patient safety, strengthen claims defensibility, and uphold the highest professional standards in aesthetic treatments.
What is consent?
At its core, consent is built on the principle of autonomy, respecting a patient’s right to make informed decisions about their own body and health. In medical practice, consent has two key meanings:
Basic consent to treatment – If a procedure is performed without any consent, this could be considered battery.
Informed consent – This involves ensuring that the patient receives clear and comprehensive information about the proposed treatment, including its purpose, benefits, risks, and any alternative options. The information must be presented in a way that is understandable to the patient, considering factors such as language and cognitive ability.
In aesthetic medicine, informed consent must always be obtained before a procedure and should be properly documented.
How to obtain informed consent
As the treating practitioner, it is your responsibility to ensure that the patient fully understands their treatment options. This includes:
- The purpose of the procedure
- The benefits of the procedure
- The risks involved
- Alternative treatments, including the option of no treatment
- Discussing Proposed Treatments and Options
Discussing proposed interventions and options
The treating practitioner must ask the patient why they want the intervention and what outcome they hope for, before assessing whether the intervention is appropriate and likely to meet their needs.
When discussing proposed medical interventions and options, a treating practitioner must consider a patient’s vulnerabilities and psychological needs. They must be sure that a request for a procedure is voluntary and that the patient has the capacity to make that decision. In order to obtain informed consent, a treating practitioner is under a duty to take reasonable care to ensure that the patient is aware of any material risks involved in any recommended treatment.
If the treating practitioner does have concerns, they should not proceed with the medical intervention until they have obtained the relevant advice from colleagues qualified to speak to those concerns.
What is a material risk?
A material risk is any risk that a reasonable patient would find significant in deciding whether to proceed with treatment. The legal test for materiality states:
“A risk is material if, in the circumstances of a particular case, a reasonable person in the patient’s position would be likely to attach significance to it, or if the doctor is or should reasonably be aware that the particular patient would be likely to attach significance to it.”
Because what constitutes a material risk is subjective, practitioners must ensure that patients are given the opportunity to accept or decline treatment with full knowledge of all possible risks.
If there are alternative treatments with lower risks that could meet the patient’s needs, these must also be discussed.
Cooling-off period and confirming consent
A cooling-off period between the consultation and treatment date allows patients time to reflect on their decision. The appropriate length of this period depends on the treatment type and the patient’s individual circumstances.
Before proceeding, the practitioner should:
- Check whether the patient’s circumstances or views have changed
- Ensure that the patient still consents to the treatment
- If a significant amount of time has passed, re-confirm consent in writing
- Consent should be seen as an ongoing process rather than a single event
Obtaining consent from non-English speakers
Language barriers can complicate the consent process and lead to disputes if a patient later claims they did not fully understand the treatment.
To ensure informed consent is obtained:
- Use a professional interpreter whenever possible
- Provide consent forms and patient information leaflets in common languages spoken within your practice
- Use visual aids, such as diagrams or videos, to help explain treatments
- Speak clearly, using simple language and avoiding medical jargon
- Use the “teach-back” method, asking the patient to repeat key information to confirm their understanding
- All discussions should be thoroughly documented to provide a record that informed consent was obtained.
Documenting consent
Proper documentation is essential to ensure that consent is valid and defensible in the event of a claim. Best practices include:
- Using a comprehensive consent form detailing the procedure, its purpose, benefits, risks, and material risks
- Ensuring the consent form is signed and dated by both the patient and the practitioner
- Talking through the consent form rather than simply handing it to the patient
- Ensuring that the person obtaining consent has full knowledge of the procedure and its risks
- Keeping detailed clinical records of consultations, including the patient’s reasons for treatment, risks discussed, and alternative options provided
- Providing written information for patients to review, such as leaflets, websites, or decision aids
A signed consent form alone does not prove that valid consent was obtained – what matters is the quality and clarity of the information given to the patient.
How long does consent last?
There is no set legal timeframe for how long consent remains valid. However, any significant delay between consent being obtained and the procedure being carried out may cast doubt on its validity.
As a general principle, the patient should be given an initial cooling off period between the initial consultation and the date of intervention. This allows them the patient time to digest the information and think about their options before they consent to the intervention.
Thereafter, it is best practice to confirm consent prior to the intervention. This is an important opportunity to explore with the patient whether there have been any material changes since consent was first taken, and to ask the patient if there are any further questions.
Obtaining the patient’s consent again is not only a final check for the patient but a final check for you to ensure that they are still suitable for the intervention that is about to be carried out. Be sure to document that the patient continues to consent to the proposed intervention.
It is not advisable to rely on a previously obtained consent.
Best practices for obtaining informed consent
To maintain high professional and ethical standards, practitioners should:
- Obtain consent personally rather than delegating the task
- Provide comprehensive information about the treatment’s purpose, benefits, risks, and alternatives
- Ensure the patient has the capacity to make an informed decision and is not being unduly influenced
- Give the patient written information to review before making a final decision
- Allow a cooling-off period to ensure the decision is well thought out
- Keep thorough records of all consent discussions
By following these steps, practitioners can enhance patient safety, reduce legal risks, and ensure they uphold best practices in aesthetic medicine.
Further reading:
GMC “Decision Making and consent”: https://www.gmc-uk.org/professional-standards/the-professional-standards/decision-making-and-consent
BMA: Consent Toolkit: https://www.bma.org.uk/media/txrnpo3s/consent-refusal-toolkit2024.pdf
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All the information provided in our Cosmetic Insure Treatment Guides and blog articles serves as a valuable reference and informational resource. Our intention is to offer insights that assist you in making informed choices when exploring the extensive array of non-surgical aesthetic treatments available.
Please note that this information does not constitute medical advice. Any reliance you place on the content found within the Cosmetic Insure Treatment Guides, Cosmetic Insure blog articles, or on any part of cosmeticinsure.com is done so entirely at your own discretion.
Prior to considering any non-surgical cosmetic treatment mentioned anywhere on cosmeticinsure.com, we strongly recommend that you engage in thorough consultation with a duly qualified and accredited practitioner who possesses the proper training and comprehensive insurance coverage for the specific treatment you are interested in. Neither the author of the guides or blog articles, nor the practitioner who has verified these guides, nor Cosmetic Insure, can be held responsible or liable for any loss or claims resulting from the use or misuse of cosmeticinsure.com’s content. Your safety and well-being are our utmost concern.
