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Informed Consent


I have just been listening to, “The Age of Consent” on BBC Radio4. The  concept of consent is one I have been interested in over my years in nursing as well as my work as a massage practitioner since taking early retirement from the NHS. In particular terms like, “implied consent” and, “informed consent.”  The latter has a clear meaning in law and it is important that the person giving consent not only understands what they are consenting to but is also in a mental state that means they are able to make a decision about consenting.  With, “implied consent” things are much more difficult. An example given in the programme was that no one consents to live in a city where pollution levels are almost constantly above legal limit. Yet millions of people do this!

In my early days in the NHS, both in general (adult) nursing and also in the field of mental health nursing, I feel often lip service was given to the idea of Informed Consent.

I am sure in retrospect that  there were times that patients did not fully  understand what they were consenting to. In my later years in nursing, this improved greatly and consent was sought explicitly, not just for medical interventions but also for psychotherapeutic interventions as these too can have side effects. Some patients go through phases when they are more suicidal as a result of thinking about where they are now and what they have been through.

So how does this apply to Massage and Aromatherapy?   On one level, a degree of consent has been given when a client books an appointment. However as part of the consultation, I need to be sure that this is informed consent! If it is the client’s first experience of massage, unless they have specifically read the information available on this site about how I work  they will not know exactly what is involved. I need to ensure the client knows that they can be in control, only removing as much clothing as they are comfortable with, being able to say no if they decide half way through that they want to withdraw their consent for something.

With this in mind, especially with new clients I often remind them that they should tell me if anything is not right for them, be that an area of the body I propose to work on, or the amount of pressure I am using etc.

I also need to be aware that some clients may feel very vulnerable, lying down on the massage table wearing only knickers/underpants, even if covered by a towel or towels. I need to explicitly check before doing anything that they might find threatening and explain what I am doing or about to do.

Of course I should do this for therapeutic reasons as well as for the ethical and legal details of consent!

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