Fitness to Practise Learnings: Consent

At a recent Professional Conduct Committee hearing, it was alleged that a registrant had failed to obtain a patient's informed consent before undertaking an intimate examination, and that they had failed to consider or provide the opportunity for a chaperone to be present.

Registrants are reminded that patients must give their consent before commencing any treatment or assessment. Where there may be a requirement for an intimate or internal examination or treatment, it must be clear that consent has been given before proceeding.

Principle E of the Code states:

Patient consent must be voluntary and informed. It is your (the registrant) duty to ensure the patient has all the necessary information and support they need in order to give it.

As detailed in the new GCC guidance on consent, registrants must obtain and document a patient's consent before removing clothing (Standard E6), provide privacy to undress and dress and offer a gown to the patient to maintain their dignity (D3). Furthermore, when dealing with a young person or child, the registrant must assess their capacity to consent (E5). Registrants must also remain aware of any cultural differences as what constitutes an intimate examination may differ from person to person.

Registrants should obtain explicit consent when conducting internal examinations, ie. specific permission to undertake a particular task, as many patients may not be aware of such chiropractic procedures and infer sexual motivation.

Chaperones

If the assessment or care involves an intimate or internal area, the patient must be offered the option of having a chaperone present (D4). The presence of a chaperone, who is acceptable to both the registrant and patient, can provide emotional comfort and reassurance to the patient and be a safeguard for both patient and chiropractor.

If either the registrant or patient does not wish the examination to go ahead without a chaperone present, the examination or treatment should be rescheduled, as long as this would not negatively impact the patient's health.

All discussions regarding chaperones must be documented in the patient's records.

Documenting consent

Registrants must ensure that all consent provided by the patient is documented before commencing any assessment or care (H3). They must use the patient's chiropractic records or a dedicated consent form to document the key elements of your discussion with the patient.

Download the new GCC guidance on consent.

PCC Determinations

The Professional Conduct Committee has made two determinations in June 2022.

Click here to review their recent decisions.