Three Elements of Valid Informed Consent: 

1. Relevant Clinical Information: At minimum: diagnosis, proposed intervention, its purpose, its risks/benefits, alternatives, and risks/benefits of alternatives (including no intervention)

2. Voluntary Decision: The decision must be voluntary and without coercion from hospital staff or family/friends

3. Capacity: Confirm patient has the ability to make a decision about the specific question being addressed Exceptions to Informed Consent:

1. Emergency: Imminent risk of death or serious harm without medical intervention. All attempts should be made to find HCP/other surrogate decision-maker. Always discuss with Attending of Record. Document emergent situation, lack of capacity, lack of available surrogate, need for emergent intervention. Consider 2nd opinion/consulting MGH lawyer-on-call.

2. Lack of Capacity or Competency: Turn to the appropriate HCP, guardian or other surrogate decision-maker



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