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Consent

As with all other services provided to children and young people, consent to work being undertaken by Occupational Therapists must be freely and knowingly given. This page sets out the guiding principles for Occupational Therapists in relation to consent.

"It is a general legal and ethical principle that valid consent must be obtained before starting treatment or physical investigation, or providing personal care for a patient. This principal reflects the right of patients to determine what happens to their own bodies, and is a fundamental part of good practice.  A health professional who does not respect this principle may be liable both to legal action by the patient and action by their professional body.  Employing bodies may also be liable for the actions of their staff".

Statement 1

Specific Consent to Occupational Therapy, assessment, intervention and sharing of information with appropriate agencies on a "need to know basis" will be obtained from the client, and clearly recorded.

Occupational Therapists are required to:

  1. Explain to the client the proposed course of action before obtaining consent, and document.
  2. Record the nature of initial consent given, whether by:

a. in writing

b. through guardian/advocate

c. other means

  1. Fully explain and gain written consent before audio recording, photographing or videoing an individual for information purposes, research, training or publication.
  2. Keep all written consent forms in the client's records.
  3. Gain consent before a student observes or provides intervention and ensure the consent and its nature are documented in the service user's record.

(College of Occupational Therapists 2003a)

Statement 2

Occupational therapists will ensure that the client is fully informed about the specific nature of the occupational therapy interventions relevant to them.  This means that their decisions on consent will be informed.

Occupational therapists are required to:

  1. Inform the client referred to occupational therapy about assessment and intervention; providing details about its purpose, nature, consequences, risks and possible alternatives.
  2. Provide information, in appropriate languages and modalities, which explain the nature and purpose of occupational therapy and sets out clearly the client's rights in consenting to occupational therapy.

(College of Occupational Therapists 2003a)

Statement 3

Occupational therapists should accept the client's decision to refuse or withdraw consent at any time, unless the individual lacks the requisite capacity to make valid decisions.

Statement 4

Occupational therapy staff have a professional and legal obligation to respect the duty of confidentiality, subject to statutory and common-law exceptions to this duty.

See "Information Sharing" Policy.

Statement 5

Occupational therapy staff should be aware of the correct legal approach to take when obtaining consent is difficult or impossible.

a) People under the age of 18Occupational therapists/occupational therapy services are required to:

  1. Ensure that the child or person under the age of 18 has a clear understanding of what is involved in treatment.
  2. Discuss with the child the advantages and advisability of having a parent/guardian present.
  3. Obtain parental/guardian consent if the child does not have sufficient understanding of what is involved in treatment.
  4. They are also required to document discussions relating to consent in the child's records, in particular:

 The nature of the consent given by the child.

  1. The consent given by a parent/guardian.
  2. The occupational therapist's reasons for believing that the child understands enough to give consent.
  3. The reasons why a child is believed not to have sufficient understanding to give consent.
  4. Discussions with the child about the advisability of having a parent/guardian present.
  5. The reasons behind any decision not to have a parent/guardian present or involved.

Occupational therapists should seek legal advice if they are concerned that disclosing a child's records to a parent/guardian or other person may act against the interests of the child.In some cases a child will require emergency treatment, but will be judged not to have the requisite mental capacity to give consent, and there will be insufficient time to gain parental/guardian consent.  In such cases, the occupational therapist to document:

 

  1. The treatment given.
  2. The reasons for the treatment being given.
  3. Obstacles to language or communication

 

Occupational therapists/occupational therapy services are required to:

 

  1. Obtain the services of an interpreter when there are obstacles to language.
  2. Obtain the client consent to the use of an interpreter at the earliest possible opportunity.
  3. Record the identified need and subsequent use of an interpreter in the client's records.
  4. Obtain communication aids where there are obstacles to communication.  Document the identified means of communication in the client's records.  Ensure that there is a procedure in place to obtain a signing interpreter or communication aids.

(College of Occupational Therapists 2003a)