Understanding Consent

Consent in healthcare applies to more than you might think at first. In ON, healthcare consent is guided by the Health Care Consent Act [1996] that describes when and how consent should be obtained for three  important scenarios. The first is consent to treatmentThe obligations of consent to treatment is described neatly by the College of Physicians and Surgeons of Ontario. Recently, there has been some controversy over the definition of ‘treatment’ that is described at length in the Rasouli case. In short, the issue is whether or not acts of omission constitute treatment under the law, the implication being that physicians might need consent even for treatments they don’t intend to offer (most notably, CPR).

The second scenario that requires consent in a healthcare context is ‘admission to care facilities‘. This process refers specifically to admission to Long-Term Care Homes as defined under the Long-Term Care Homes Act (2007). In Ontario, the Community Care Access Centres are responsible for managing admissions to Long-Term Care. Individuals may be offered Long-Term Care placement from their home, or increasingly from acute care hospitals once it becomes clear that independent living may no longer be possible. Individuals may choose up to five homes on which they wish to be added to a wait list. Some excellent resources regarding this process can be found here.

The thirds scenario that requires consent in a healthcare context is ‘personal assistance services‘. These services are coordinated again by the Community Care Access Centres and typically involve private healthcare providers coming to your home for:

assistance with or supervision of hygiene, washing, dressing, grooming, eating, drinking, elimination, ambulation, positioning or any other routine activity of living, and includes a group of personal assistance services or a plan setting out personal assistance services to be provided to a person, but does not include anything prescribed by the regulations as not constituting a personal assistance service.”

These services are now being frequently used as a bridge between acute care and long-term care where long-term care resources are not yet available for individuals as a preferred model to keeping patients in hospitals unnecessarily