Revisiting the role of consent in neonatal medicine: legal considerations and the need for empirical research

Consent to treatment renders a medical or surgical treatment lawful. Consent should be considered more of a fluid process than an event. Consent does not and should not ever just equate with the signature of a patient or family member on a consent form. A family’s agreement to treatment allows the clinician ‘approval to treat’ through implied ‘proxy’ consent (assent). This practice is commonplace in neonatal medicine and is often complemented by a written record in the medical notes. However, available data indicate that approx-imately three-quarters of UK neonatal units have no guidelines for obtaining consent and that there is substantial variation in practice in obtaining consent for different neonatal procedures.