Skip to main content

Witnessing vs. obtaining consent: what's the difference?

Case study about a nurse's role and responsibilities in the consent process

In the course of admitting Mr. Yan for his procedure, Susan notices the procedure consent form—typically completed at the physician's office or the pre-admission clinic— is not signed.

 

Susan tries to confirm with Mr. Yan that he has consented to the procedure, but they are having difficulty understanding each other. When Susan asks questions in English, Mr. Yan responds in Cantonese. Susan calls a hospital interpreter. 

When the interpreter arrives, Susan learns that Mr. Yan did speak to the physician performing the procedure. He states, through the interpreter, that he knows he needs the procedure and agreed to have it at this time. He remembers little else about the conversation.

What are Susan's professional responsibilities?

Susan knows when she is involved in care or treatment provided by another health professional, she has a professional responsibility and ethical obligation (as per the Professional Standards) to respect and promote the client’s right to be informed and make informed choices. Regardless of whether Mr. Yan has signed the consent form, Susan knows she must:

  • Confirm Mr. Yan’s identity and verify that he has consented to the procedure
  • Check to see if he has sufficient information and understanding about the procedure, and if not, help him understand the information provided by the physician
  • Advocate for him to get more information as needed​
Can Susan witness Mr. Yan's signature?

​Agency policy may allow Susan to witness Mr. Yan’s signature but this does not mean she is obtaining consent. The act of witnessing a signature on a consent form is different than the process of obtaining consent. Susan knows it’s not appropriate for her to take responsibility for obtaining consent for care or treatment provided by another health professional. In this situation, it’s the surgeon’s responsibility to obtain informed consent from Mr. Yan.

What does Susan do?

​With the interpreter’s help, Susan learns Mr. Yan has additional questions about his surgery. She calls the surgeon, letting her know she’ll need to speak with Mr. Yan before the procedure, and that an interpreter will be needed. She documents the conversations with Mr. Yan and the surgeon in Mr. Yan’s record and follows her agency policy for completing the consent form.

 Need help?

​​​For further information on the Standards of Practice or professional practice matters, contact us:

  • Email practice@bccnm.ca
  • 604.742.6200 x8803 (Metro Vancouver)
  • Toll-free 1.866.880.7101 x8803 (within Canada only)

Share your thoughts

How helpful was this case in understanding your professional responsibility?



Submit

Thank you. Your feedback has been submitted.