Can I delegate my consent discussion to a registrar?<\/h3>\t\t\t\n\t\t\t\t
You can delegate some parts of the consent discussion to an appropriately skilled health practitioner. Depending on the procedure and your hospital’s policies, this may be a registrar. If you are performing the procedure, you must be satisfied the patient has received the information they need and given informed consent before you proceed.<\/p>\n
Before asking a registrar to undertake the discussion, consider whether they have the necessary knowledge, skills and information. They need to understand what the procedure involves, its purpose, expected benefits, alternatives (including not proceeding), and its general and material risks.<\/p>\n
They also need enough information about the patient to tailor the discussion to their circumstances, priorities and concerns. These may include fertility, sexual function or recovery.<\/p>\n
You should discuss the procedure with the registrar and ensure you have been clear about the planned procedure and any foreseeable circumstances that might require a different approach or additional intervention. The registrar needs enough information to discuss these possibilities and their implications with the patient.<\/p>\n
It is also important to make sure the patient is told who may perform the procedure and what supervision will be provided. Confirm the registrar can explain these arrangements and knows how to contact you or another experienced clinician if they cannot answer a question.<\/p>\n
Always encourage the registrar to pause and seek help rather than guess or feel pressured to obtain a signature. They should feel comfortable telling you if they are not equipped to conduct the discussion and know when to escalate any of the patient’s concerns. This can also provide an opportunity to guide their learning. Check your hospital’s policies about who can undertake consent discussions for particular procedures.<\/p>\n\t\t\t
Checking consent before a procedure<\/h3>\t\t\t\n\t\t\t\t
If you are taking over a public hospital list, you may not have met the patient or conducted the consent discussion. Review the consent form and clinical record, then speak directly with the patient.<\/p>\n
Questions such as “can you tell me what procedure you are having today?” and “are there any questions or concerns you would like to discuss?” can help you gauge their understanding.<\/p>\n
Confirm they want to proceed, understand who will perform the procedure and have had an opportunity to ask questions. Check if material risks for the patient have been addressed.<\/p>\n
Clarify the scope of their consent. Consent to a biopsy should not be assumed to include removal of a lesion. Discuss foreseeable additional interventions beforehand, including when they might be needed and any limits the patient places on their consent.<\/p>\n
An unexpected finding does not, by itself, mean you can proceed with an additional non-urgent procedure.<\/p>\n
Address any gaps in the discussion and document the patient’s decision. If valid consent remains uncertain, delay the procedure where clinically appropriate. Document any agreed interventions, limitations and supervision arrangements.<\/p>\n
Consent can evolve throughout care. Open discussions and checking the patient’s understanding help keep consent aligned with their wishes and the proposed treatment.\u00a0<\/p>\n\t\t\t
Further resources<\/h3>\t\t\t\n\t\t\t\t
Avant collection page – Consent in care: beyond the form<\/a><\/p>\n Avant webinar – Consent in care: beyond the form<\/a><\/p>\n
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