Informed Consent in Nursing Practice: A Critical Analysis

This essay delves into the critical issue of informed consent within contemporary nursing practice. It begins by defining informed consent and its significance in ensuring patient autonomy and well-being, highlighting the necessity of patient awareness regarding treatment procedures, risks, and alternatives. The discussion encompasses the process of informed consent, emphasizing the nurse's role in facilitating shared decision-making, verifying patient understanding, and providing psychological support. The essay addresses issues and challenges associated with informed consent, such as patient refusal based on beliefs, language barriers, and patient expectations, as well as the complexities of obtaining consent from vulnerable populations. Furthermore, it explores Gillick Competence, a legal concept determining a child's ability to consent to medical treatment. The essay concludes by underscoring the importance of informed consent in clinical trials and patient rights, while acknowledging potential challenges and advocating for prioritizing patient safety and well-being within healthcare organizations. The essay is supported by relevant academic references.

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Introduction
Informed consent means that the patient who is taken care of should be informed about the
treatment procedures and plans that have been taken up by the healthcare professionals.
Treatment procedures should only begin if the patient agrees to receive it. The patient must
be fully aware and informed about what is going to happen to him, the risks, objectives and
alternatives of the treatment procedure. If the patient does not give consent, then the nurses or
other healthcare practitioners will not have the permission to carry out the given
process(Grady, 2018). It is essential to take approval from a patient irrespective of the
procedure, whether it's a physical examination, diagnosis or other medical assessment. The
primary purpose of the nurses is to ensure patient satisfaction and their well-being, so the
opinions and needs of the patients should be given the highest priority. Moreover, the law of
consent is an essential ethical consideration in medical purpose and legality of human rights.
The whole concept of informed consent is based on respect for another person, beneficence
and justice.
Discussion
Process of informed consent
Before any surgery, the informed consent process should be performed, which helps to
facilitate shared decision making between the surgeon and the patient. However, nurses have
the responsibility to make the patient fully aware and informed about the legal and ethical
considerations of the informed consent process(Katz, Webb & Committee on Bioethics,
2016). A nurse will be held responsible and accountable for the verification of the patients
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have successfully signed the document of informed consent in their presence. Both the patient
and the legal representatives should be eligible and competent to provide consent. The nurses
need to understand the value of informed consent; they should give psychological support
and respect the patient's decision and opinion, enhance the understanding of the patient about
a particular situation, provide them information disclosure(Tamariz et al, 2019). The nurses
should forward to build a good interpersonal relationship between the nurse and a patient.
Role of nurse in the informed consent
The nurse should ensure that all the patients are getting adequate high-quality care. It is their
responsibility to inform the patients about the treatment plan and explain the medical
procedures to them so that there is clarity of thoughts between the nurse and the patients and
transparency in the whole treatment approach(Parkhouse, 2018). The nurse should respect the
patient's decision when they refuse a treatment procedure and should not pressurize the
patient to go for the same.
Issues with informed consent
The concept of informed consent resulted in greater autonomy. Through informed consent,
both the patient and the healthcare providers play an equal role in formulating an acceptable
plan for medical treatment. But the liberty provided to the patients through informed consent
has brought some serious issues in healthcare. Some patients deliberately refuse a particular
medical assessment or a treatment approach based on religious beliefs or other grounds. And
the healthcare providers also cannot subject patients to a specific perioperative test without
the consent of the patient(Grady, 2018). This result in deterioration in the quality of
healthcare provided to the patient and may worsen the patient's condition also. Some other
barriers of informed consent may include the complexity of the treatment and inability of the
patient to understand information due to a poor health condition or language barriers(Scott,
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2016). Language constraints between the nurse and the patient can lead to misunderstandings.
It often happens that a patient signs the consent form without being fully aware of what they
are signing, that results in several complexities in the later stages of treatment(Adams et al,
2017). Issues with informed consent can also arise from false expectations of the patient
about the experiment outcomes since many patients fear that they will be treated as an
'experimental model' for educating the student nurses. Majority of the patient believe that
clinical trials will bring extra burden in their life, so they stick to the conventional treatment
method. Convincing and getting consent from such patient is most challenging for a
nurse(Larner & Carter, 2016). On the other hand, if the nurse shares detailed information
about the potential ill-effects of a treatment procedure, the patients will get more scared and
will refuse to go for the surgery. So, the patient's perception plays a significant role in
informed consent approval(Mâsse, O’Connor, Tu, Hughes, Beauchamp & Baranowski,
2017). Lastly, obtaining informed consent from a vulnerable group of people or people
having learning disabilities is most challenging and requires suitable strategies for adequately
communicating with such patients.
Gillick Competence
The concept of Gillick Competence originated in England(Harling, 2017). It is a part of
medical law which decides whether a child is eligible to decide on his own whether he needs
a particular therapy or treatment(McCrory & Jacobs, 2018). A child can give consent to a
specific medical treatment without the need for parental or supervisory permission. Gillick
competence is based on the ability of a child to assess or understand the risk factors
associated with the chosen treatment procedure, the ability to understand the problems and
implications or alternative treatment options(Smith, 2018). Through Gillick competence, a
child will be able to decide on his own. Children at or over the age of 16 are assumed to be
Gillick competent. If a child who is Gillick competent refuses to accept any medical
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examination or treatment procedure, the law does not allow another person to consent in his
place(Griffith, 2016). But sometimes, this can happen, if a Gillick competent child refuses a
treatment which may lead to severe health complication or even death of the child, then their
decisions can be overruled.
CONCLUSION
Though informed consent has some potential challenges and issues, still it is an essential
method in a clinical trial which fosters the entry of new therapeutic interventions into
healthcare. Moreover, it gives the freedom or liberty to the patients to decide whether they
will go for a particular therapy or not. However, it should be noted that the patients should
not misuse this power for their own benefit. The rights, safety and well-being of the patient
should always be given a priority in any healthcare organization so that a patient does not feel
being deceived off or cheated in the name of social cause.
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