Informed clinical consent: what you need to know

Understanding informed clinical consent is just as important as knowing about your procedure.

Charmaine Yabsley
July 2018

If you’re having a medical procedure, you may have to sign an informed clinical consent form. Before you sign, make sure you understand what’s going to happen, what the benefits and potential risks are and ask any questions you have about your procedure. This isn’t the same as informed financial consent (which we’ll get to later).

We answer some commonly asked questions.

What is informed clinical consent?

Before a doctor, nurse or other healthcare professional treats or examines you, they need your consent. For significant treatments or procedures, and if it involves anaesthetic, you’ll be asked to sign an informed consent form. As signing the form means you agree to the procedure, make sure you understand your options and risks before you sign it.

Before your appointment with your doctor, make a list of questions you want to ask. This will help you make an informed decision about your treatment.

There may be times when you’re unable to provide consent, if you’re unconscious for example. In emergency situations the doctor will go ahead with the treatment if it will prevent significant pain or serious damage to your health.

Can I change my mind after signing a consent form?

If you no longer wish to have the procedure or treatment, you can withdraw your consent, even after you’ve signed the form.

What should I know before signing a consent form?

Before signing a consent form, be clear on the following:

• What does the procedure involve?
• Are there alternatives?
• What are the general risks involved, and how common are they?
• Are there any risks specific to me?
• How will the outcome of treatment affect my lifestyle?
• What’s the likely outcome if I decide not to be treated?
• Will it involve a stay in hospital?
• Will it involve an anaesthetic?
• How long will the procedure take?
• How long will it take me to recover?
• Will someone need to collect me afterwards?
• How should I take care of myself immediately after the procedure?
• If my symptoms become worse, who should I contact?
• Where can I get more information and support?
• Do I need to make another appointment, and should I bring someone with me?

“It’s important to remember that your appointment and procedures are about your health, and your healthcare, so don’t feel embarrassed or shy about asking questions. Or asking your healthcare practitioner to explain anything you don’t understand or feel unsure about,” says Brian Osborne, HCF hospital negotiations manager.

“Remember, you can always ask for a second opinion from another healthcare professional.”

If you’re unsure what you should be asking before you sign an informed consent form, see the Question Builder, or the HCF Preparing for hospital tool, which includes questions about a range of common procedures.  

What’s informed financial consent?

Before your procedure it’s important you’re aware of any out-of-pocket costs you may have to pay. This is known as a ‘gap’ payment. Knowing how much your treatment will cost, and agreeing to it, is called informed financial consent.

If you have private hospital insurance, ask your health fund whether your policy covers the procedure. You may need to get the relevant Medicare item numbers from your doctor to get the full picture. An item number is the unique code assigned to every service Medicare covers.

Hospitals and the doctors who treat you bill separately for their services so you need to establish the costs for both upfront.

Hospitals

HCF members who choose one of the many private hospitals we have an agreement with, known as participating hospitals, won’t face a gap payment for hospital costs for services they’re fully covered for. You will need to check whether you’ll need to pay an excess though and whether you’ll have a gap for doctors' fees.

Doctors

Ask your doctor or specialist how much their fee will be, and if there’ll be a gap payment. Ask for this information in writing.

Some hospitals may have forms they’ll ask you to sign to show you understand the cost. The cost will be an estimate however, as issues can come up in surgery that result in additional fees.

Also ask if any other doctors will be involved. Sometimes a surgeon will need an anaesthetist or assistant surgeon. If so, find out how much their fee will be.

HCF members can search for providers who participate in our ‘No Gap’ (no out-of-pocket) or ‘Known Gap’ (a set out-of-pocket amount) arrangements to minimise costs.

To see typical costs for a range of common procedures use our Preparing for hospital tool.