Policy statement: Informed consent

The World Confederation for Physical Therapy (WCPT) expects physical therapists to ensure that the patient/client or responsible party (parent, spouse, guardian, caregiver, etc) has given appropriate consent before any physical therapy is undertaken.

Informed consent[Note] is based on the moral and legal premise of patient/client autonomy, whereby a patient’s/client’s decision to participate in examination/assessment, evaluation, diagnosis, prognosis/plan, intervention/treatment and re-examination, as well as in any research activity, is freely given by a competent individual: who has received the necessary information; who has adequately understood the information; and who, after considering the information, has arrived at a decision without having been subjected to coercion, undue influence, inducement, or intimidation.

Patients/clients have the right to make decisions about their own participation in examination/assessment, evaluation, diagnosis, prognosis/plan, intervention/treatment, re-examination, as well as in any research, without their physical therapist trying to influence the decision. Patient autonomy does allow for physical therapists to educate the patient/client, but does not allow the physical therapist to make the decision for the patient/client. Informed consent protects the individual's freedom of choice and respects the individual's autonomy.[1] [2] [3] [4]

Competent individuals should be provided with adequate, intelligible information about the proposed physical therapy. This information should include a clear explanation of:

  • the planned examination/assessment
  • the evaluation, diagnosis, and prognosis/plan
  • the intervention/treatment to be provided
  • the risks which may be associated with the intervention
  • the expected benefits of the intervention
  • the anticipated time frames
  • the anticipated costs
  • any reasonable alternatives to the recommended intervention

The physical therapist should ascertain the ability of the patient/client to understand the above before seeking consent. When the individual is not deemed competent or when the patient/client is a minor, a legal guardian or advocate may act as a surrogate decision-maker.

Physical therapists should record in their documentation that informed consent has been obtained.[5]

Physical therapists working in team situations are responsible for ensuring that appropriate consent arrangements have been made prior to any examination/assessment, intervention or research.  While another member of the team may acquire the consent , it does not negate the physical therapist's responsibility for ensuring that the patient/client is properly informed about the physical therapy service to be rendered.

WCPT encourages its member organisations to ensure that:

  • physical therapists comply with all national and local legal and procedural requirements for informed consent
  • the responsibility of the physical therapist in relation to informed consent is an essential component of entry level professional physical therapist education programmes
  • the responsibility of the physical therapist in relation to informed consent is included in professional standards, codes of conduct and ethical principles

Glossary

Documentation — is the process of recording of all aspects of patient/client care/management including the results of the initial examination/assessment and evaluation, diagnosis, prognosis, plan of care/intervention/treatment, interventions/treatment, response to interventions/treatment, changes in patient/client status relative to the interventions/treatment, re-examination, and discharge/discontinuation of intervention and other patient/client management activities.[5]

Informed consent — is a decision to participate in assessment, treatment or research, taken by a competent individual who has received the necessary information; who has adequately understood the information; and who, after considering the information, has arrived at a decision without having been subjected to coercion, undue influence or inducement, or intimidation. Informed consent is based on the principle that competent individuals are entitled to choose freely whether to participate in assessment, treatment or research. Informed consent protects the individual's freedom of choice and respects the individual's autonomy. In order to obtain the valid consent of patients for assessment, treatment or participation in research, they must be informed of all potential and significant risks, benefits and likely outcomes of treatment, taking into account their age, emotional state and cognitive ability, to allow valid/informed consent to be given.[1] [3]

 

Approval, review and related policy information
Date adopted:

Originally approved at the 13th General Meeting of WCPT June 1995.

Revised and re-approved at the 16th General Meeting of WCPT June 2007.

Revised and re-approved at the 17th General Meeting of WCPT June 2011.
Date for review: 2015
Related WCPT Policies:

WCPT ethical principles

WCPT policy statements:

WCPT endorsements:
References
  1. The Chartered Society of Physiotherapy. Core standards of physiotherapy practice. London, UK: Chartered Society of Physiotherapy; 2005.  (Access date 22nd March 2010)
  2. Council of International Organizations of Medical Science. Ethical Guidelines for Biomedical Research Involving Human Subjects. London, UK: CIOMS; 2008.  (Access date 23rd March 2010)
  3. European Region of World Confederation for Physical Therapy. European Core Standards of Physiotherapy Practice. Brussels, Belgium: ER-WCPT; 2008. (Access date 22nd March 2010)
  4. World Confederation for Physical Therapy. Policy statement: Research. London, UK: WCPT; 2011.   (Access date 22nd September 2011)
  5. World Confederation for Physical Therapy. WCPT guideline for records management: record keeping, storage, retrieval and disposal. London, UK: WCPT; 2011.  (Access date 22nd September 2011)

[Note] WCPT understands the term informed consent to be valid consent.