CLINICAL AUDIT

Dentists' Understanding of Consent to Treatment: A Port Harcourt Private Dental Practice Perspective- A Clinical Audit

Table of Contents

Chapter 1: Introduction3

Background of the study3

Problem Statement5

Purpose of the study6

Rationale of the study6

Significance of the study8

Research Questions9

Chapter 2: Literature Review10

Chapter 3: Methodology24

Research Design24

Procedure24

Sample Size24

Data collection25

The design25

Data Analysis25

References27

Chapter 1: Introduction

Background of the study

A patient's informed consent to investigations or treatment is a fundamental aspect of the proper provision of dental care. Without informed consent to treatment, a dentist is vulnerable to criticism on a number of counts, not least those of assault and/or negligence - which in turn could lead respectively to criminal charges and/or civil claims against the dentist. (Margaret, 1991: 25) Furthermore, the question of consent arises increasingly at the heart of complaints made under the NHS Complaints Procedure, and complaints to the General Dental Council on matters on professional ethics and conduct.

It is self-evident, therefore, that every practising dentist, therapist and hygienist needs not only a thorough understanding of the principles of consent, but also an awareness of how to apply these principles in the wide variety of circumstances that can arise in the practise of dentistry. (Dawson, 2009: 124)

The law is continually changing and developing, as the courts interpret both the common law and legislation. The doctrine of precedent means that judgements from a higher court will bind a lower court. At the same time, clinical knowledge and ability have developed, and this makes the interpretation of what constitutes informed consent and who can give it, a constantly changing perspective. (Manson, 2007:88)

Clinicians have a responsibility to ensure that every effort is made to keep abreast of changing standards, to show not only that the optimum treatment is being given to their patients, but also that the patients themselves have had the best opportunity to be involved in decision making about the care of their bodies. (Shaw, 2007: 75)

Nearly eighty years ago, Judge Cardozo in a case in America declared:

“Every human being of adult years and sound mind has a right to determine what shall be done with his own body”. (Corrigan, 2009: 88)

The concept of patients' rights, adult responsibility and a mind sound enough to understand, are embodied in the principles of consent. In 1990 The Department of Health, in its advice booklet on obtaining consent, has defined consent as;

…The voluntary and continuing permission of the patient to receive a particular treatment. It must be based upon adequate knowledge of the purpose, nature and likely effects and risks of that treatment, including the likelihood of its success and any alternative to it…. (Hale, 2007: 156)

The Human Rights Act 1998 came into force in October 2000, putting into effect in English Law, the European Convention of Human Rights. Courts are expected to take into account case law from the European Court of Human Rights in Strasbourg as well as English Law. An understanding of the law concerning consent must bear in mind the relevant articles which might be invoked in medical law cases, notably Article 2 (protection of right to ...