Consent to examination and treatment - Barts Health NHS Trust

COR/POL/046/2012-001
Withdrawal of consent
2.55 A patient with capacity is entitled to withdraw consent at any time, including
during the performance of a procedure. Where a patient does object during
treatment, it is good practice for the practitioner, if at all possible, to stop the
procedure, establish the patient’s concerns and explain the consequences of not
completing the procedure. If stopping the procedure at that point would genuinely
put the life of the patient at risk, the practitioner may be entitled to continue until
the risk no longer applies.
2.56 Assessing capacity during a procedure may be difficult but the practitioner should
try to establish whether at that time the patient has the capacity to withdraw a
previously given consent. If capacity is lacking, it may sometimes be justified to
continue in the patient’s best interests, although this should not be used as an
excuse to ignore distress.
3 PATIENTS WHO LACK CAPACITY TO GIVE OR WITHHOLD CONSENT
3.1 This section is included in the Barts Health Consent Policy to reflect the
implementation of the Mental Capacity Act 2005 and replaces material previously
included in the 2001 NHS Model Consent Policy.
3.2 The Mental Capacity Act provides a statutory framework to empower and protect
adults aged 16 or over who lack capacity to make their own decisions.
Assessing capacity
3.3 The Mental Capacity Act 2005 is recent legislation which is intended to empower
and protect adults 16 and over who may lack capacity to consent to treatment. A
checklist of issues which must be considered when assessing and documenting
capacity is included in Appendix D.
3.4 The Act sets out a two stage test and assessment for capacity in an adult patient.
Stage 1: Does the person have an impairment of, or a disturbance in the
functioning of, their mind or brain?
Stage 2: Does the impairment or disturbance prevent the person from
making a particular decision?
3.5 It is a “decision-specific” and time specific test. The Act makes it clear that a lack
of capacity cannot be established merely by reference to a person’s age,
appearance or behaviour.
3.6 A person is unable to make a decision if they cannot:
understand the relevant information
retain that information
use the information as part of the decision making process
3.7 An apparent lack of capacity to give or withhold consent may in fact be the result
of communication difficulties rather than genuine incapacity. You should involve
appropriate colleagues in making such assessments of incapacity, such as
specialist learning disability teams and speech and language therapists, unless
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