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

• The patient gives it voluntarily without any coercion
• The patient has the capacity and competence to give consent
• The patient has the minimum level of adequate information pertaining to the nature of the procedure he is giving consent for.

On the other hand, the concept of informed consent has been developed by the courts in the US while retaining the basic requirements of consent, which shifts the focus 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 the 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:

• 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.”