 Hello everyone, welcome back to a new session on dentistry and more. So in today's session, we'll be seeing about the consent. The last class, we had covered the ethical principles. So I was talking about the most vital principle that is autonomy. So in autonomy, that is the respect of person, the respecting the person to choose the decision. So that is the consent. So most of the experiments which was done in the last 1915, prior to 1915, time all were without any consent. So in today's world or present scenario, the most important ethical principle is autonomy or the consent. So if we do any study, if we are doing any procedure, any medical procedure or even if we are doing a question as study, we need to get a proper written consent. Otherwise, it will not be valid, it will not be accepted anywhere. So the consent is the most crucial principle of ethics. So let's say what is the definition given by the Indian Contract Act 1872. The consent is defined as when two or more person agree upon the same thing in the same sense, they are said to be consent. So who can give consent? So who are the eligible people can give a consent? So consent can be given by any conscious mentally sound people with 12 years or more. So that is given in the Indian Penal Code 1860. So that is under coming section 88 and 90. So that is consent. So consent can be given by people with 12 years or more conscious and mentally sound. But regarding the contract, that should be about 18 years. If two people are entering into a contract, both parties should be more than 18 years. Then only become a valid contract can be produced to court as a contract under contract law. The doctor-patient relationship is also considered as a contract. So it is always advisable that a doctor should get a proper written consent from the patient. If the patient is a minor that is less than 18 years, the consent should be obtained from the patient's parent or guardian who is definitely will be more than 18 years. So it is always advisable to get a written consent and only it will be if any problem arises you can produce it as an evidence in the court. Otherwise it cannot be produced as a proper evidence. So when consent is not valid, if a person is giving consent under fear, fraud or misinterpretation of facts by any person who is ignorant of the implication or who is under 12 years, how will this become invalid if the fear or we are trying to misinterpret the real facts and getting the consent and a person who is very ignorant about the outcome implication of the consent like mad person or a very rebellious type person who is mentally not conscious, mentally not sound or anyone who is under 12 years, all this consent will not be valid. So these are the basic types of consent that is implied consent, express consent, informed and proxy consent. So in various instances in our medical practices, all these are coming into action that is first one implied or acid consent. It is just like it is a default consent. We are going to a doctor, we are going to a dentist. The implied consent is automatically there because we are ready to get examined. We are okay to get examined. We are giving consent to get examined. Otherwise we wouldn't have gone there. We wouldn't have gone to the patient, to the dentist or a doctor. We are going there means that we are ready to get examined. So that is implied consent or tacit consent. But whereas it doesn't imply that this examination involves very complex procedures that inspection, palpation, percolation, escutation and routine, sonography, examination machine involves blood, drawing of blood for the diagnostic purpose, always express consent. Express consent should be there, that is patient should express his consent orally or in a written format. Then only we can do the procedure. So let's see what is oral and express consent. So express consent, so basically we have two types. It is not like the tacit or implied consent, it is tacit or implied consent is automatically comes when a patient enters to a clinic, a patient appears before a doctor. But the express consent is different. The patient has to express it for a general examination, the tacit or implied consent is fine. But more complicated or less complicated, the express consent should be there. So oral consent is obtained for minor examinations, therapeutic procedures, preferably the presence of a disinterested third party, it should be always a third party, it should not be the relative, it should be an disinterested third party. So express consent, if it is in the oral form, we can get it for minor examination. But if it is a very complicated like general anesthesia for any surgical operation, we should always get an expressed written consent, not oral consent. Written consent should be obtained for all major diagnostic procedures. That is they are expressing it, not just implying it. So oral consent for the minor procedures and the written consent for the major procedures. So these are the express consent, so implied consent and the express consent. So next comes the informed consent. So the express consent, the problem is the patient might not be knowing in detail about the procedure, complications, procedure, detailing, the other options. So the patient, the doctor says that this patient needs surgery. The patient or bystander in a third party is giving a consent. And the informed consent, perfect consent where the patient or the participant will be knowing about in and out of the procedure. That is what is the diagnosis, what is the nature of treatment is being given, what are the risks involved in the procedure and what would be the success and diagnosis if the procedure is not performed. And if any alternative methods are available. So we should tell the patient everything in patients that is non-medical terms, patient should comprehend it. So informed consent has basically few attributes like it should be voluntary, it should be comprehensible, the patient should understand what the doctor or the researcher is saying should be able to comprehend it and the consent should be voluntary. So the patient will be informed about in detail about the procedure then patient can decide about giving a consent. So that is informed consent. So informed consent is the most perfect consent because the patient is in detail about the procedure just like the doctor. So proxy consent is always like it can all the above consent like plate consent, express consent like oral consent. Plate consent is automatically there, express oral and express written consent can take a proxy consent like parent for child, the party or the patient is a child, the proxy consent can be given and for a mentally unsound unconscious patients or relatives can give proxy consent on behalf of these people. So they can give expressed oral consent or expressed written consent on behalf of these people that becomes proxy consent. So situations where consent may not be obtained that is medical emergencies in case of persons suffering from mutifiable disease or immigrants for armed forces or new admission to prisons in case of person were caught may order for psychiatric examination in such cases there is no need for consent and even for a request of a police. So that is all about various types of consent. Most important consent is informed consent. Basically the types are implied or tacit consent or express consent. Express consent has two types that is oral and written consent. So informed consent is when the patient is being informed in that of the procedure becomes informed consent and all of these proceed all of these consent can become a proxy consent if the patient or the participant is a child or a mentally unsound unconscious patient. So that is all about consent. So consent is coming under the principle of autonomy and autonomy is the most important and most crucial principle it takes so thank you.