What is the difference between real and informed consent?


Dr KK Aggarwal and Ms Ira Gupta    11 April 2018

There is a difference in the nature of express consent of the patient, known as ‘Real’ consent in the United Kingdom (UK) and as ‘Informed’ consent in the United States (US).

According to Department of Health in the UK, consent is the voluntary and continuing permission of the patient to receive a particular treatment based on an adequate knowledge of the purpose, nature and likely risks of the treatment including the likelihood of its success and any alternatives to it. Permission given under any unfair or undue pressure is not consent. The elements of consent are defined with reference to the patient and consent is considered to be valid and ‘real’ when:

  1. The patient gives it voluntarily without any coercion
  2. The patient has the capacity and competence to give consent
  3. The patient has the minimum of adequate level of information about the nature of the procedure to which he is consenting to.

On the other hand, the concept of ‘informed’ consent developed by the courts in the US, while retaining the basic requirements of consent, shifts the emphasis to the duty of the doctor to disclose the necessary information to the patient to secure his consent. It is an agreement for a proposed medical treatment or nontreatment or for a proposed invasive procedure. It requires physicians to disclose the benefits, risks and alternatives to the proposed treatment, nontreatment or procedure. It is the method by which fully informed, rational persons may be involved in choices about their healthcare.

Taber’s Cyclopedic Medical Dictionary defines ‘Informed’ consent as below:

“Consent that is given by a person after receipt of the following information:

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

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