What is Consent? What is Assent?

Many people use the terms consent and assent interchangeably, but they hold distinct meanings. While both are crucial in ethical and legal contexts, understanding their differences is important. So, how do we assess both consent and assent? Let’s break it down.

Defining the Terms

At its core, consent refers to explicit permission or agreement to allow something to happen. It is commonly used in legal and ethical settings, particularly in scenarios involving care or treatment. In some cases, a person who is being cared for may not be able to provide consent themselves, and in such cases, a caregiver must give consent on their behalf.

Assent, on the other hand, represents a general agreement to participate, but it is not limited to a verbal yes. Assent includes both verbal and nonverbal communication, like body language or other actions, indicating willingness or reluctance to participate. While consent and assent can sometimes overlap, their differences are essential to acknowledge.

An Example of Consent and Assent

Consider the example of a child whose parents have given consent for them to play on the playground. The child verbally expresses interest in going outside and playing. However, once outside, the child lingers near the classroom door and avoids interacting with the equipment or other children. This illustrates that while parental consent was obtained, the child did not assent to the activity. There could be many reasons for this—perhaps the child didn’t like the heat, misunderstood the plan, or felt uncomfortable playing with others. The key point is recognizing the distinction and importance of both consent and assent.

Consent and Assent in Action

In a professional or therapeutic context, consent typically begins with a document called “informed consent.” This document outlines what will happen during an intervention, including potential risks and benefits, procedures involved, confidentiality policies, and who will be part of the treatment. The purpose is to ensure that all parties involved are fully informed and agree to the terms of the treatment.

While assent is not usually documented in an informed consent form, it remains just as important. Assent is ongoing and should be continually assessed, especially as treatment progresses. The frequency of formal assessment should be outlined in the informed consent, and it should be revisited whenever a goal is achieved or the treatment plan changes. Keep in mind, assent may look different for each individual, which is why building a strong rapport is essential to ensure their wishes are respected.

The Importance of Consent and Assent in Promoting Autonomy

It is vital to remember that both consent and assent are essential for upholding autonomy in decision-making. For example, before touching a child, it is crucial to ask for their consent. If that’s not feasible (as in situations where safety is at risk), it’s still necessary to inform the child about what is happening and why, even if they are unable to give explicit consent. Paying attention to their reactions and respecting their wishes in future decisions is key to maintaining a respectful and autonomous approach to care and interaction.

Consent vs. Assent: Understanding the Difference

While the terms “consent” and “assent” are often used interchangeably, they have distinct meanings. Both are crucial in ethical and legal contexts, particularly in healthcare and therapeutic settings.

Consent

Consent refers to explicit permission or agreement for something to happen. It is usually required in situations involving care or treatment. If a person is unable to provide consent themselves, a caregiver may do so on their behalf.

Assent

Assent signifies a general agreement to participate. It can be expressed through both verbal and nonverbal communication, such as body language or actions, indicating willingness or reluctance. While consent and assent can sometimes overlap, it is important to recognize their differences.

Example

A child whose parents have consented to them playing on the playground may still not assent to the activity. If the child expresses reluctance or avoidance once on the playground, it indicates a lack of assent, despite parental consent.

Consent and Assent in Practice

In professional settings, consent often begins with an “informed consent” document that outlines the details, risks, benefits, and procedures involved in a treatment or intervention. Assent, although not usually documented in the same way, is equally vital and should be continually assessed throughout the treatment process. The frequency of assent assessment should be outlined in the informed consent and revisited whenever the treatment plan changes.

Promoting Autonomy

Both consent and assent are crucial for upholding autonomy in decision-making. Even when explicit consent is not feasible, as in situations where safety is at risk, it is still important to inform the individual and respect their wishes as much as possible.

Suddha Mukhopadhyay M.A., BCBA