Skip to main content

Witnessing vs. obtaining consent: what's the difference?

Case study about a nurse's role and responsibilities in the consent process

This case study was revised November 8, 2016 to reflect feedback from nurses. Many thanks to those who shared their knowledge and insight.

In the course of admitting Mr. Yan for same-day surgery, Susan notices the surgical consent form, typically completed at the surgeon’s office or the pre-admission clinic, is not signed.


Susan tries to confirm with Mr. Yan that he has consented to surgery, but they are having difficulty understanding each other. When Susan asks questions in English, Mr. Yan responds in Cantonese. Susan calls a hospital interpreter. When the interpreter arrives, Susan learns that Mr. Yan did speak to the surgeon. He states, through the interpreter, that he knows he needs the surgery and agreed to have it at this time. He remembers little else about the conversation.

What are Susan's professional responsibilities?

Susan knows when she is involved in care or treatment provided by another health professional, she has a professional responsibility and ethical obligation to respect and promote the client’s right to be informed and make informed choices. Regardless of whether Mr. Yan has signed the consent form, Susan knows she must:

  • Confirm Mr. Yan’s identity and verify that he has consented to the surgical procedure
  • Check to see if he has sufficient information and understanding about the surgery, and if not, help him understand the information provided by the surgeon
  • Advocate for him to get more information as needed
Can Susan witness Mr. Yan's signature?

Agency policy may allow Susan to witness Mr. Yan’s signature but this does not mean she is obtaining consent. The act of witnessing a signature on a consent form is different than the process of obtaining consent. Susan knows it’s not appropriate for her to take responsibility for obtaining consent for care or treatment provided by another health professional. In this situation, it’s the surgeon’s responsibility to obtain informed consent from Mr. Yan.

What does Susan do?

With the interpreter’s help, Susan learns Mr. Yan has additional questions about his surgery. She calls the surgeon, letting her know she’ll need to speak with Mr. Yan before the procedure, and that an interpreter will be needed. She documents the conversations with Mr. Yan and the surgeon in Mr. Yan’s record and follows her agency policy for completing the consent form.

 Need help?

For further information on the Standards of Practice or professional practice matters, contact us:

  • Telephone 604.736.7331 ext. 332
  • Toll-free in Canada 1.800.565.6505
  • Email

Share your thoughts

Rate this content


Thank you. Your feedback has been submitted.

Home > Nursing standards > Case studies & practice resources > Ethics > Consent > Witnessing vs. obtaining consent: what's the difference?