Informed consent is a central ethical and legal principle in the provision of health care, including nursing and midwifery care.  The requirement to obtain informed consent applies to all health interventions with certain well-defined exceptions (such as life-threatening situations) (2). The requirement for consent to be ‘informed’ is justified on the ethical grounds of: 

• avoiding harm, unfairness, and exploitation, and 
• protecting a person’s autonomy or self-determination (2). 

The requirements of informed consent include disclosure of all relevant information, comprehension (the person must understand the information being given and the implications of consent), competence (the person must be capable of making the decision), and consent must be freely given (voluntary) (2). Informed refusal can also be the outcome of the process. 
For example, it is a legal requirement before undertaking HIV testing that a person provides informed consent (with rare exceptions such as where a legal order is made for compulsory testing or in emergencies) (33). This means that the person agrees to testing based on understanding the procedure, the reasons for testing and is capable of evaluating the personal implications of testing (34). In cases where routine HIV testing is recommended (such as in pregnancy), informed consent should still be obtained. Breaches of the requirement to obtain informed consent can have serious consequences, including harm to patients and legal repercussions for the health worker (34). 

Ethical nursing and midwifery care means treating each person as unique and assisting them to participate in informed decisions about their care (including refusing treatment or care) without disadvantage due to appearance, language, culture, religion, age, sexuality, economic status, disability, or health status.  This approach ensures respect for the client’s autonomy and upholds their right to informed consent.