In these days patients have a considerable say on the nature of their treatment. So the Patentís approval is called for on the course of treatment to be followed even in routine non-critical cases. Consent must be Ďcompetent consentí in the true sense of the term.
When the patient is capable of understanding the information given regarding his proposed treatment and the implications or consequences thereof, he is considered to have capacity to consent.
The consenting patient must be free from the influence of medicine and not under intoxication. The doctor or hospital authorities should not procure his consent under duress or coercion. Consent is also not proper if the patient has been misled into it.
Consent can be written or verbal or may also be given by conduct. For instance when somebody is standing in a queue for receiving vaccination with others, he is holding himself out to be ready and willing for the same.
Consent can also be inferred in emergency. For instance, in sudden unexpected life threatening situations in course of surgery for which consent is there, similar consent is also implicit for allowing the doctors to take further steps necessary to prevent fatal injury or death.
In case of children parent or guardian must consent to medical treatment. However, self-supporting and independent or married minors can give their own consent. Senior minors on the verge of attaining majority are also deemed capable of giving consent to treatment for their benefit and with low risk.
A mental patient need not necessarily be always incapable of giving consent; He may still have the ability to understand the nature of a proposed course of treatment. Many states or jurisdictions have recognized the right of hospitalized mental patients to decline antipsychotic drugs, which can have adverse side effects.
When a patient is incompetent, in the strict legal sense only the legally appointed guardian can take treatment decisions on his behalf. However, in such case to avoid a time consuming and lengthy competency hearing, the doctors refer to any of the Patentís family members who is concerned with his well being.
Legal and ethical issues also arise in cases where the intended medical procedure is not primarily for the Patentís welfare such as organ donation. Courts and appropriate authorities have endorsed organ transplantation proposals where the donor and the donee are closely related or emotionally attached. Here love, affection and emotional ties are the determining factors that outweigh all other considerations.
Under the provisions of some state statutes minors can give consent or overrule parental nod in certain sensitive situations such as pregnancy, drug abuse or venereal diseases.
Courts have often overturned parentís denial of consent to life saving treatment or low risk medical procedures designed for the benefit of the minor for that would constitute child neglect. Moreover, when in spite of endangered child life parents have withheld consent to life saving procedures courts have not hesitated to appoint legal guardians for the minors at the instance of the hospital authorities, who would take treatment decisions for the benefit of the minor.
In exceptional cases courts overrule competent adultís denial of life saving treatment, when the patient has minor children or is too weak to take a considered decision.