To help identify learning opportunities and facilitate communication between kinesiologists and CKO, we launched a series of Practice Standard and Guideline surveys in March 2024. The fifth survey was about the Practice Standard – Consent and Practice Guideline – Consent. This survey was published in the June issue of @CKO, the College’s official e-newsletter.
We are pleased to provide a report on the survey results. Some of the highlights:
In situations where a person is incapable of giving or refusing consent with respect to a particular treatment, consent may be given or refused on that person’s behalf by a substitute decision-maker.
- Section 20 of the Health Care Consent Act, 1996 includes a listing of substitute decision-makers, ranked in order from 1 (highest rank) to 8 (lowest rank).
- The list is also included in the Practice Standard – Consent
- The highest “rank” is “1. The incapable person’s guardian of the person, if the guardian has authority to give or refuse consent to the treatment.”
Asking patients/clients to sign consent forms is a common practice for many kinesiologists. However, consent involves more than the act of reading and signing a consent form. The Practice Standard – Consent notes that:
- “Obtaining consent is an ongoing and evolving process involving continuous discussions with a patient/client and not a single event of a patient’s/client’s signature on a consent form.”
Also, from the Practice Guideline – Consent:
“The signature of a patient/client or of the SDM on a consent form is not conclusive proof that the member obtained informed consent. This is true even if the consent form contains detailed information about the nature of the treatment and the risks involved. A signed consent form is only an indicator that a discussion surrounding consent took place.
In addition to any consent form, the member should make detailed notes in the patient’s/client’s records regarding the nature and content of the discussion around consent and follow all other documentation protocols and standards. In a situation where the member is relying on implied consent, the notes should be sufficient that a reasonable person could assume consent based on the circumstances outlined in the notes.”
Generally, consent can either be express or implied.
- Express consent is given directly, either in words (verbally) or in writing, by a patient/client or their substitute decision-maker.
- Implied consent is inferred from signs, actions, or facts, or by inaction or silence. The standard that is applied is whether a reasonable person in the same circumstances would believe that consent was given.
- There are situations where implied consent should not be relied upon. In general, as stated in the Practice Guideline – Consent, the more serious an intervention is or the more invasive a procedure is, the greater the need for express consent.
Finally, it is important that kinesiologists think about and follow all legislation and rules that apply to consent, including situations where consent may be required for the collection, use, storage and disclosure of personal information and/or personal health information.
We’d like to thank everyone who took the time to respond, and we look forward to your continued engagement with this survey series!
Questions and/or feedback about the survey, and Practice Standards and Guidelines?
Email: professionalpractice@coko.ca.