3.8 The centrality of consent
In the last 30 years there has been a strong move away from paternalism towards an emphasis on users' rights and involvement in the decision-making process. Nowadays, few users would accept treatment without knowing what it was or a health carer who withholds information about other treatment options. The importance of involving the user is exemplified by the need for practitioners to gain informed consent. This need to gain consent is enshrined in law, as well as being a central aspect of most professional codes of ethics. Competent users must be given a thorough explanation of what will be done, the risks involved in going ahead or not going ahead with the proposed treatment, and information about alternatives to the treatment. Therefore, the practitioner should have effective communication skills, because the information needs to be conveyed so that the user understands it. When giving consent, the user's decision must be voluntary and not subject to coercion. Failure to obtain consent is considered an extremely grave matter. If consent has not been obtained, and the user is harmed, they can sue the practitioner for medical negligence (for gaining inadequate consent). If the user has not been given any information or has been treated against their express wishes, they can sue the practitioner for battery (for not gaining consent at all). In addition, failure to gain consent can lead to disciplinary proceedings and the removal of the practitioner's right to practise.
So far, very few users have sued CAM practitioners, which is often attributed to CAM being more ‘patient-centred’. It is debatable what this means in terms of information exchange. CAM practitioners have the same duty to obtain consent to treatment as other health professionals (Stone, 2002).