{"id":1286,"date":"2024-11-27T14:58:57","date_gmt":"2024-11-27T19:58:57","guid":{"rendered":"https:\/\/live-coto.pantheonsite.io\/?page_id=1286"},"modified":"2026-02-10T18:17:52","modified_gmt":"2026-02-10T23:17:52","slug":"understanding-consent","status":"publish","type":"page","link":"https:\/\/www.coto.org\/public\/working-with-an-occupational-therapist\/understanding-consent\/","title":{"rendered":"Understanding Consent"},"content":{"rendered":"\n<p>Download PDF: (<a href=\"https:\/\/www.coto.org\/wp-content\/uploads\/2024\/11\/understanding-consent-information-for-patients-clients-and-caregivers.pdf\" data-type=\"attachment\" data-id=\"1300\" target=\"_blank\" rel=\"noreferrer noopener\">English<\/a>&nbsp;|&nbsp;<a href=\"https:\/\/www.coto.org\/wp-content\/uploads\/2024\/11\/coto-comprendre-le-processus-d-obtention-du-consentement.pdf\" data-type=\"attachment\" data-id=\"1299\" target=\"_blank\" rel=\"noreferrer noopener\">French<\/a>)<\/p>\n\n\n\n\n<div class=\"content-section-block has-fade-in-up  align wp-block-acf-content-section\" id=\"section-understanding-consent\">\n    <div class=\"section-header \">\n        <h2>Understanding Consent<\/h2>\n            <\/div>\n\n    <div class=\"content-section\" aria-hidden=\"false\">\n        <div class=\"acf-innerblocks-container\">\n\n<figure class=\"wp-block-image size-medium is-resized\" style=\"margin-top:var(--wp--preset--spacing--small);margin-right:0;margin-bottom:var(--wp--preset--spacing--small);margin-left:0\"><img loading=\"lazy\" decoding=\"async\" width=\"640\" height=\"427\" src=\"https:\/\/www.coto.org\/wp-content\/uploads\/2024\/11\/ot-obtaining-consent-1-640x427.jpg\" alt=\"a care worker or medical professional or housing officer makes a house call to a senior client at her home . She is discussing the senior woman\u2019s options on her digital tablet.\" class=\"wp-image-1304\" style=\"width:400px\" srcset=\"https:\/\/www.coto.org\/wp-content\/uploads\/2024\/11\/ot-obtaining-consent-1-640x427.jpg 640w, https:\/\/www.coto.org\/wp-content\/uploads\/2024\/11\/ot-obtaining-consent-1-768x513.jpg 768w, https:\/\/www.coto.org\/wp-content\/uploads\/2024\/11\/ot-obtaining-consent-1.jpg 1200w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/figure>\n\n\n\n<p>Should you sign a contract without understanding what\u2019s in it? Or let a mechanic work on your car without getting an estimate and giving your approval? Not really.<\/p>\n\n\n\n<p>The same idea is true when it comes to working with an occupational therapist (OT) or any other health care professional.<\/p>\n\n\n\n<p>Patients and clients have the right to make decisions about their treatment and other health care services. It\u2019s up to health care providers to make sure that happens. That\u2019s called informed consent.<\/p>\n\n\n\n<p>For all health care providers, it\u2019s one of the standards of the profession. People can\u2019t consent without being informed. That means you need to understand:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>the purpose and expected outcomes of a treatment\/service;<\/li>\n\n\n\n<li>the potential benefits and risks;<\/li>\n\n\n\n<li>any reasonable alternatives; and<\/li>\n\n\n\n<li>the consequences of refusing and not having the treatment\/service.<\/li>\n<\/ul>\n\n\n\n<p>It\u2019s all about getting enough information from a health care professional so that you can voluntarily make the best decision for you.<\/p>\n\n<\/div>\n    <\/div>\n<\/div>\n\n\n\n<div class=\"content-section-block has-fade-in-up  align wp-block-acf-content-section\" id=\"section-what-does-informed-consent-look-like\">\n    <div class=\"section-header \">\n        <h2>What does informed consent look like?<\/h2>\n            <\/div>\n\n    <div class=\"content-section\" aria-hidden=\"false\">\n        <div class=\"acf-innerblocks-container\">\n\n<p>Consider someone who has had a stroke and is now transitioning back to life at home. Part of that might include a visit from an OT.<\/p>\n\n\n\n<p>In this case, the OT would explain that they\u2019re going to look at the impact of the stroke and see how the individual manages around their home. How does the individual get dressed or make a meal, for instance. This may involve a physical assessment, like seeing how the person moves, so the OT will run through what\u2019s going to happen and why.<\/p>\n\n\n\n<p>At various stages, the OT can check in: \u201cIs that okay, can I keep going?\u201d The OT can also invite questions and reinforce that the patient is in control: \u201cIf you feel uncomfortable at any point or want to ask me anything, we\u2019ll stop what we\u2019re doing.\u201d<\/p>\n\n\n\n<p>The responsibility is on the OT to confirm that you comprehend (that\u2019s the informed part) and have either stated or otherwise signified agreement (the consent part).<\/p>\n\n\n\n<p>Consent can be oral (like saying okay), written (signing a form) or implied. For example, if an OT needs you to move your arm and you stick it out and follow instructions, that can be implied consent. If, on the other hand, you grimace and move away, that can be taken as a sign you haven\u2019t consented.<\/p>\n\n\n\n<p>As the patient or client, you\u2019re entitled to say yes or no, and take time to think first. Ask as many questions as you need. What is being done? Why? Will any information be shared (like the results of an assessment)? Get clear explanations, without any jargon.<\/p>\n\n\n\n<p>\u201cTo confirm that it\u2019s okay to proceed, the OT needs to use language that meets the needs of the client,\u201d says Sandra Carter, Practice Advisor for the College of Occupational Therapists of Ontario.<\/p>\n\n\n\n<p>You shouldn\u2019t feel rushed or pressured. The obligation is on the health care provider to ensure you\u2019re informed and have given consent (or not) to every aspect of a course of action, which means looking for obvious signs that you understand.<\/p>\n\n<\/div>\n    <\/div>\n<\/div>\n\n\n\n<div class=\"content-section-block has-fade-in-up  align wp-block-acf-content-section\" id=\"section-the-choice-is-yours\">\n    <div class=\"section-header \">\n        <h2>The choice is yours<\/h2>\n            <\/div>\n\n    <div class=\"content-section\" aria-hidden=\"false\">\n        <div class=\"acf-innerblocks-container\">\n\n<p>Even after you\u2019re given consent, you have the right to change your mind \u2013 at any time, and for any reason.<\/p>\n\n\n\n<p>Consent must be specific to a treatment or service. So if you give consent to one thing, it doesn\u2019t mean you are consenting to&nbsp;<em>everything<\/em>. Turning down a recommended approach also doesn\u2019t necessarily mean you\u2019re not giving consent to anything at all.<\/p>\n\n\n\n<p>Changing an approach requires new consent. Take an OT working with a client to find the right bath seat. Let\u2019s say the one being tested isn\u2019t suitable. So, the OT suggests an alternative piece of equipment, like a tub transfer bench, and gives the reasons (the seat would be unsafe), risks and limitations (the bench costs more and is harder to remove from the tub) and benefits (the bench is safer and sturdier, with less risk of a fall).<\/p>\n\n\n\n<p>With all of that information provided and discussed, the OT asks for the client\u2019s approval to proceed with testing out a transfer bench.<\/p>\n\n\n\n<p>In all instances, your OT needs to run through the options, and explain the pros and cons associated with each. And also respect your decisions. It\u2019s all about you, and your OT should never make decisions for you.<\/p>\n\n\n\n<p>This is all a legal right, covered in the&nbsp;<em><a href=\"https:\/\/www.ontario.ca\/laws\/statute\/96h02\" target=\"_blank\" rel=\"noreferrer noopener\">Health Care Consent Act<\/a><\/em>. The only exceptions are emergency situations, where someone is at serious risk if a treatment isn\u2019t delivered promptly.<\/p>\n\n<\/div>\n    <\/div>\n<\/div>\n\n\n\n<div class=\"content-section-block has-fade-in-up  align wp-block-acf-content-section\" id=\"section-what-is-a-substitute-decision-maker\">\n    <div class=\"section-header \">\n        <h2>What is a substitute decision-maker?<\/h2>\n            <\/div>\n\n    <div class=\"content-section\" aria-hidden=\"false\">\n        <div class=\"acf-innerblocks-container\">\n\n<p>An important principle is that consent is based on capacity. In other words, people must be capable of giving consent.<\/p>\n\n\n\n<p>Not everyone is. A person is able to make decisions about a treatment if they\u2019re able to understand the relevant information and appreciate the implications of a decision or lack of decision.<\/p>\n\n\n\n<figure class=\"wp-block-image size-full is-resized\" style=\"margin-top:var(--wp--preset--spacing--small);margin-right:0;margin-bottom:var(--wp--preset--spacing--small);margin-left:0\"><img loading=\"lazy\" decoding=\"async\" width=\"573\" height=\"465\" src=\"https:\/\/www.coto.org\/wp-content\/uploads\/2024\/11\/Culture.jpg\" alt=\"\" class=\"wp-image-618\" style=\"width:400px\"\/><\/figure>\n\n\n\n<p>A person is presumed to be capable of making health care decisions unless there are reasonable grounds to suspect incapacity, like an intellectual disability. If someone isn\u2019t capable, an OT can seek consent from what\u2019s called their substitute decision-maker. That\u2019s someone who has been authorized to provide or refuse consent on someone else\u2019s behalf. It could be the patient\u2019s or client\u2019s spouse or child, for example. An OT would have to go through the same process with the substitute decision-maker as they would with the patient or client.<\/p>\n\n\n\n<p>Remember that for any person, capacity can vary over time. Also, the same person might be capable of some decisions but not all.<\/p>\n\n\n\n<p>The right to informed consent isn\u2019t a single event but an ongoing process \u2013 and a big part of working with a health care professional.<\/p>\n\n\n\n<p>If you have questions about what to expect when working with an occupational therapist, contact the College at 1-800-890-6570\/416-214-1177 x240 or&nbsp;<a href=\"mailto:practice@coto.org\">practice@coto.org<\/a>.&nbsp;&nbsp;We\u2019re here to help.<\/p>\n\n<\/div>\n    <\/div>\n<\/div>\n\n\n\n<div class=\"content-section-block has-fade-in-up  align wp-block-acf-content-section\" id=\"section-more-resources\">\n    <div class=\"section-header \">\n        <h2>More Resources<\/h2>\n            <\/div>\n\n    <div class=\"content-section\" aria-hidden=\"false\">\n        <div class=\"acf-innerblocks-container\">\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/www.coto.org\/resources\/standard-for-consent-2023\/\" data-type=\"resource\" data-id=\"391\" target=\"_blank\" rel=\"noreferrer noopener\">Standard for Consent<\/a><\/li>\n\n\n\n<li><a href=\"\/resources\/?resource-audience=public\">Patient and Client Resources<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.coto.org\/resources\/professional-obligations\/\" data-type=\"resource\" data-id=\"2415\">Professional Obligations<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.coto.org\/registrants\/professional-obligations\"><\/a><a href=\"https:\/\/www.coto.org\/clientsandthepublic\/protecting-the-public\"><\/a><a href=\"https:\/\/www.coto.org\/registrants\/professional-obligations\"><\/a><a href=\"https:\/\/www.coto.org\/public\/public-protection\/\" data-type=\"page\" data-id=\"163\">Public Protection<\/a><\/li>\n<\/ul>\n\n<\/div>\n    <\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Download PDF: (English&nbsp;|&nbsp;French)<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":157,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"wp-custom-template-sidebar-page","meta":{"_acf_changed":false,"advanced_seo_description":"Understanding informed consent as it relates to working with an occupational therapist.","jetpack_seo_html_title":"","jetpack_seo_noindex":false,"footnotes":""},"class_list":["post-1286","page","type-page","status-publish","hentry"],"acf":[],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.coto.org\/wp-json\/wp\/v2\/pages\/1286","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.coto.org\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.coto.org\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.coto.org\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.coto.org\/wp-json\/wp\/v2\/comments?post=1286"}],"version-history":[{"count":9,"href":"https:\/\/www.coto.org\/wp-json\/wp\/v2\/pages\/1286\/revisions"}],"predecessor-version":[{"id":7849,"href":"https:\/\/www.coto.org\/wp-json\/wp\/v2\/pages\/1286\/revisions\/7849"}],"up":[{"embeddable":true,"href":"https:\/\/www.coto.org\/wp-json\/wp\/v2\/pages\/157"}],"wp:attachment":[{"href":"https:\/\/www.coto.org\/wp-json\/wp\/v2\/media?parent=1286"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}