Skip to main content

Witnessing vs. obtaining consent: what's the difference?

Case study about a nurse's role and responsibilities in the consent process

In the course of admitting Mr. Yan for his procedure, Susan notices the procedure consent form—typically completed at the physician's office or the pre-admission clinic— is not signed.

 

Susan tries to confirm with Mr. Yan that he has consented to the procedure, but they are having difficulty understanding each other. When Susan asks questions in English, Mr. Yan responds in Cantonese. Susan calls a hospital interpreter. 

When the interpreter arrives, Susan learns that Mr. Yan did speak to the physician performing the procedure. He states, through the interpreter, that he knows he needs the procedure and agreed to have it at this time. He remembers little else about the conversation.

What are Susan's professional responsibilities?

Susan knows when she is involved in care or treatment provided by another health professional, she has a professional responsibility and ethical obligation (as per the Professional Standards) to respect and promote the client’s right to be informed and make informed choices. Regardless of whether Mr. Yan has signed the consent form, Susan knows she must:

  • Confirm Mr. Yan’s identity and verify that he has consented to the procedure
  • Check to see if he has sufficient information and understanding about the procedure, and if not, help him understand the information provided by the physician
  • Advocate for him to get more information as needed​
Can Susan witness Mr. Yan's signature?

​Agency policy may allow Susan to witness Mr. Yan’s signature but this does not mean she is obtaining consent. The act of witnessing a signature on a consent form is different than the process of obtaining consent. Susan knows it’s not appropriate for her to take responsibility for obtaining consent for care or treatment provided by another health professional. In this situation, it’s the surgeon’s responsibility to obtain informed consent from Mr. Yan.

What does Susan do?

​With the interpreter’s help, Susan learns Mr. Yan has additional questions about his surgery. She calls the surgeon, letting her know she’ll need to speak with Mr. Yan before the procedure, and that an interpreter will be needed. She documents the conversations with Mr. Yan and the surgeon in Mr. Yan’s record and follows her agency policy for completing the consent form.

​​Need help or support?​

For further guidance on understanding and applying the standards of practice, contact our team by completing the Standards Support intake form.​

900 – 200 Granville St
Vancouver, BC  V6C 1S4
Canada

info@bccnm​.ca
604.742.6200​
​Toll-free 1.866.880.7101 (within Canada only) ​


We acknowledge the rights and title of the First Nations on whose collective unceded territories encompass the land base colonially known as British Columbia. We give specific thanks to the hən̓q̓əmin̓əm̓ speaking peoples the xʷməθkʷəy̓əm (Musqueam) and sel̓íl̓witulh (Tsleil-Waututh) Nations and the Sḵwx̱wú7mesh-ulh Sníchim speaking Peoples the Sḵwx̱wú7mesh Úxwumixw (Squamish Nation), on whose unceded territories BCCNM’s office is located. We also give thanks for the medicines of these territories and recognize that laws, governance, and health systems tied to these lands and waters have existed here for over 9000 years.

We also acknowledge the unique and distinct rights, including rights to health and wellness, of First Nations, Métis, and Inuit peoples from elsewhere in Canada who now live in British Columbia. As leaders in the settler health system, we acknowledge our responsibilities to these rights under international, national, and provincial law.​