Types of Consent
Expressed consent is given verbally or in writing by a competent adult. Implied consent assumes a patient who is unconscious or otherwise unable would want life-saving care. Minors generally require parental consent, except in emergencies where delay would risk harm.
Capacity and Refusal
A patient has capacity if they understand the situation, the risks of refusing, and can communicate a choice. Alcohol, drugs, head injury, and hypoglycemia can impair capacity. Explain risks clearly, offer alternatives, and involve medical direction.
Documentation
Document the patient's orientation, the information you provided, and their understanding. Obtain a signature and witness when possible. Record that the patient was told they can call again at any time.