The nature of express consent of the patient differs - known as ‘Real’ consent in UK and as ‘Informed’ consent in the US.

The Department of Health, UK states that consent is the voluntary permission given by the patient to receive a particular treatment on the basis of adequate knowledge of the purpose, nature and the possible risks of the treatment, including the odds of its success and any alternatives to the treatment. Permission given under any unfair or undue pressure is not considered as consent. Consent is considered to be valid and ‘real’ when:

• It is voluntary without any coercion;
• The patient has the capacity and is competent to give consent;
• The patient has the minimum of adequate level of information about the nature of the procedure to which he is giving consent.

The concept of ‘informed’ consent, developed by the US courts, retains the basic requirements of consent, but shifts the emphasis to the duty of the doctor to disclose the necessary information to the patient to attain his consent. It refers to an agreement for a medical treatment or non-treatment or for an invasive procedure. Physicians are required to disclose the benefits, risks and alternatives to the proposed treatment, non-treatment or procedure. Through this, fully informed, rational individuals are involved in choices about their healthcare.

Taber’s Cyclopedic Medical Dictionary defines ‘Informed’ consent as: “Consent that is given by a person after receipt of the following information:

• The nature and purpose of the proposed procedure or treatment
• The expected outcome and the likelihood of success
• The risks
• The alternatives to the procedure and supporting information regarding those alternatives
• And the effect of no treatment or procedure, including the effect on the prognosis and the material risks associated with no treatment.
• Also included are instructions concerning what should be done if the procedure turns out to be harmful or unsuccessful”.