Informed Consent in Complementary and Integrative Care

What consent is

Consent means a person gives permission before receiving a treatment, test or examination. The NHS (the public health service in the United Kingdom) states that for consent to be valid it must be voluntary and informed, and the person must have the capacity to make the decision. [1] The NHS page is written for UK health services. Legal rules for private complementary practitioners differ by country and state, so this page describes the principles and does not give legal advice.

The three parts

• Voluntary. The decision must be yours and not influenced by pressure from staff, friends or family. [1] A practitioner who pressures you to buy a package of sessions or products is not respecting this.
• Informed. You should be told what the treatment involves, including benefits and risks, whether there are reasonable alternative treatments, and what will happen if treatment does not go ahead. [1]
• Capacity. You must understand the information and be able to use it to decide. [1]

What to expect to be told before a complementary treatment

A practitioner should be able to explain, in plain words:

• What will happen in the session, including any touching, needles, heat or other procedures.
• What the evidence is for your specific problem, honestly labeled. NCCIH says to ask for scientific evidence, not just personal stories. [2]
• Possible side effects. For acupuncture, for example, NCCIH reports that complications are relatively few, but nonsterile needles and improper delivery have caused harm. [3]
• Other options, including conventional care, and what could happen if you delay conventional care. NCCIH advises against using an unproven product or practice to postpone seeing your provider. [2]
• Costs, including any products or tests they will recommend.

Your right to ask, pause or stop

Under the principle of consent, you can change your mind. The NHS says that if someone changes their mind before a procedure, they are entitled to withdraw their previous consent. [1] In practice, you can ask for a session to stop, ask for a break, or decline a technique. Saying so is always allowed, and a respectful practitioner will explain and offer alternatives.

Touch, boundaries and body-based therapies

For massage and other hands-on therapies, consent also covers where and how you are touched and what is draped. See massage practitioner qualifications, consent and boundaries.

Children and others who cannot consent alone

The NHS notes that someone with parental responsibility may need to give consent for a child up to the age of 16 to have treatment. [1] Rules differ elsewhere. See therapies for children and older adults.

Red flags about consent

• You are asked to sign a form promising a cure or giving up your right to see a doctor.
• You are told to stop prescribed medicine. Do not stop it without first talking to your doctor. [4]
• Delays to conventional care are suggested as part of the plan. For more, see red flags, delayed care and informed consent in naturopathic practice.