Consent and dental practice are not mutually exclusive. However, the importance of consent in dentistry is often overlooked. Consent is the fundamental aspect of dental care. Meanwhile, it is also required to give the patient the necessary information regarding the procedure including the risk and benefits of the treatment plan.
Dentists must recognise that a patient has a right to informed consent as well as the right to make an informed refusal. While these decisions might not include the life and death situations - certain choices in dental decisions might be potentially harmful to the patients.
Types of Consent
Voluntary - Voluntary consent is based on the personal decision of the patient without any external pressure.
Informed - This kind of consent requires that the patient must know about the nature, purpose, benefits, material risks and alternatives to the proposed treatment plan. This also includes the knowledge about the outcome of no treatment.
Capacity - Capacity identifies as the person must be in the place to understand the information provided to him and use it to make an informed decision.
Once the patient authorises the dentist for the procedure or a comprehensive treatment plan, they provide the dentist with informed consent. This compromises two steps. First, the dentist obtains the documented information and disclosure. Secondly, the dentist must interact and communicate to obtain a truly informed decision.
Age Implications Of Consent
Not all individuals are in the position to make informed consent. Children, the elderly and patients who are physically or mentally compromised are often supervised by a guardian who assumes that function. Children who are 16 years or under - if they are competent enough to make a decision they can do so without permission from a parent or guardian. According to the guidelines it is important to discuss the treatment plan with both the children and the parents simultaneously. This enhances the development of a supportive e environment adequate for a successful treatment plan.
How To Seek Consent?
● In general practice, it is a legal and ethical implication that all dentists and assistants must ask for consent before starting the treatment.
● A senior member of the dental facility obtains consent on behalf of the dental team. However, this is not always practical.
● The dental team members have a responsibility to verify whether consent has been obtained before starting treatment.
The language barrier can be a major factor hindering the consent process. In such instances, other communication options such as the use of a translator or another family member must be pursued to ensure the patient fully understands the choices and their consequences.
Evidence Of Consent
Usually, verbal consent is enough to gain the confidence and approval of the patient. However, a written document is needed in cases of dispute. While a signature implies that consent has been taken - it is important to understand that consent is an ongoing process and not just a signature. Once the consent form is signed, no changes shall be made to the treatment plan. In cases when changes are needed, the patient must be informed in advance and if necessary get a new form signed by the patient.
