Communication
CPSA · Communication · Consent & shared decision
Consent for a procedure
Valid consent = capacity + information + voluntariness. Explain the procedure, its benefits, risks and alternatives (incl. doing nothing), and check understanding — per Montgomery, tailored to what matters to this patient.
The framework
Confirm the basics
- Confirm identity and that you’re the right person to consent (or would escalate)
- Assess capacity for this decision (understand, retain, weigh, communicate)
Explain the procedure
- What it involves, why it’s recommended, and the intended benefit
- The material risks (common and serious) — per Montgomery, what a reasonable patient in their position would want to know
- Alternatives, including the option of doing nothing
Check & decide
- Check understanding; answer questions; ensure the decision is voluntary (no coercion)
- Confirm consent and document; provide written information
Phrases that work
- “I’d like to explain the procedure and the risks so you can decide.”
- “The main risks I need to tell you about are…”
- “There are alternatives, including not having it — let me explain those too.”
- “What questions do you have before you decide?”
Pitfalls that lose marks
- Listing only benefits and glossing over serious risks.
- Not mentioning alternatives / the option of no treatment.
- Failing to assess capacity or check understanding.
- Consenting for a procedure beyond your competence (should escalate).