Necessary or not? The ethics of consentless care in hospitals

Patients who are unable to make decisions for themselves put hospital staff in a difficult position: either skip needed care, or go ahead without proper consent. A new study explores how nurses and other healthcare workers think about the ethics of treating patients who cannot give consent.

The article, published in Nursing Ethics, focus on everyday decisions in medical wards where staff often have to act quickly and make tough calls about what is best for patients. The study is needed, since there is insufficient knowledge about how staff in this context reason about the ethical dilemmas they encounter.

The researchers interviewed 37 staff members from five different professions in eight group discussions. Most participants supported using care without consent in their daily work. They felt it was often necessary and easy to justify, especially when patients were confused, when treatment was clearly helpful, or when others’ safety was at risk.

Still, the study found that decisions were not always based just on patient needs. Sometimes, hospital culture, like staff shortages or routines, pushed people to act without consent. The researchers suggest that with better support, some of this care might not be needed at all.

“Suboptimal ward culture was considered a prime driver of consentless measures and a force that compromises for instance nurses’ agency in the patient encounter. In the light of this, there is reason to believe that some consentless care could be avoided,” says Niklas Juth, Professor of Medical Ethics, Research Leader at the Centre for Research Ethics & Bioethics at Uppsala University, and co-author of the study.

Do you want to know more? Read the article: Björk J, Juth N, Godskesen T. Ethical reflections of healthcare staff on ‘consentless measures’ in somatic care: A qualitative study. Nursing Ethics. 2025;0(0). DOI: 10.1177/09697330251328649

By Fanny Klingvall