Your Rights: Informed Consent and Decision-Making

A patient's guide to informed consent for vascular access procedures — your right to understand, ask questions, agree, or refuse — and what happens if you cannot make decisions for yourself.

patient-education•Feb 2026•Patient Rights

Your Rights: Informed Consent and Decision-Making

Before any significant vascular access procedure — including placement of a PICC line, central venous catheter, implanted port, or other invasive device — you have the right to be fully informed and to make your own decision. This guide explains what that means in practice.

Informed consent is not just a signature on a form. It is a conversation between you and your care team. By the end of that conversation, you should:

  1. Understand what procedure is being proposed and why
  2. Know the risks and benefits
  3. Know what alternatives exist, including the option to decline
  4. Have had your questions answered in language you can understand
  5. Freely agree — without pressure — to proceed (or choose not to)

The signed form documents that this conversation happened. The conversation itself is what matters.

What Your Care Team Is Required to Tell You

Before any vascular access procedure requiring formal consent, your clinician must explain:

1. What the procedure is

A clear, plain-language description of the device being placed, where in your body it will go, and how the procedure is done. For example: “We are going to place a PICC line — a long, thin flexible tube — into a vein in your upper arm. Using ultrasound, we’ll guide it through the vein until the tip sits in a large vein just above your heart. You’ll receive local anesthetic so you won’t feel much more than pressure.”

Your clinician should explain what clinical goal the device will accomplish — what medications or treatments it will enable — and why this type of catheter is the recommended choice for your situation.

3. The risks

Honest discussion of what can go wrong. Risks are not shared to frighten you, but because you need the full picture to make a meaningful decision. Common risks discussed include:

  • Infection at the site or in the bloodstream
  • Bleeding or bruising
  • Blood clot in the vein
  • Damage to nearby structures (nerve, artery) — rare
  • Catheter moving out of position
  • Procedure not working and needing to be repeated

The specific risks vary by procedure type and your individual health situation.

4. The alternatives

What other options exist? Could a different type of catheter work? Could the medication be given orally instead? What would happen if you chose not to have the procedure at all? You should understand the alternatives and their trade-offs before agreeing.

5. What happens if you decline

If you choose not to have the procedure, what are the likely consequences? Your clinician should explain this honestly — not to pressure you, but so your decision is fully informed.

You have the right to ask questions — as many as you need

No question is too basic or too detailed. If you do not understand something, say so. Ask the clinician to explain it again, in different words, with more detail, or more simply. You can also ask:

  • “Can you draw me a picture of where this goes?”
  • “What would you recommend for someone in my situation?”
  • “Can I have a day to think about this before I decide?”

You have the right to have a support person present

A family member, trusted friend, or advocate can be with you during the consent discussion. This person can help you remember what was said, ask additional questions, and support your decision-making.

You have the right to an interpreter

If English is not your first language, or if you are more comfortable in another language, qualified interpreter services must be provided. Family members and friends are generally not appropriate interpreters for medical consent discussions — a trained medical interpreter (in person or via phone/video) should be used to ensure nothing is lost or softened in translation.

You have the right to take your time

For elective (non-emergency) procedures, you should not be rushed. A consent form being placed in front of you five minutes before you are wheeled into a procedure room is not ideal. If you feel pressured or rushed, you can say: “I am not comfortable signing this right now. I need more time and more information.”

You have the right to change your mind

Even after signing a consent form, you can change your mind and withdraw consent up until the procedure begins. If you decide you do not want to proceed, tell your care team. Withdrawal of consent is always respected.

You have the right to refuse

You have the unconditional right to refuse any vascular access procedure, even if refusing may result in not receiving a recommended treatment, or even if the consequences might be serious. A care team that respects your rights will explain the consequences of your refusal clearly and document your decision — and they will not retaliate against you or reduce the quality of your other care because you declined a procedure.

If you are considering refusing a recommended catheter, ask your team: “Is there any alternative way to get my treatment that does not require this?” There may be options you were not aware of.

When a Procedure Is an Emergency

In a true emergency — when an IV line or catheter is urgently needed to save your life or prevent serious harm, and you are unable to speak for yourself (unconscious, severely altered) and no family member or representative is reachable — your care team may proceed with the procedure without formal consent. This is called the emergency exception to informed consent.

If this happens, your care team is required to:

  • Document exactly why the emergency exception was used
  • Explain to you (when you are able to understand) or to your family what happened and why
  • Obtain your agreement to continue care once you regain the ability to participate in decisions

The emergency exception is narrow — it applies to true life-threatening emergencies, not to situations where getting consent would simply be inconvenient.

If You Cannot Make Decisions for Yourself

Sometimes illness, sedation, severe pain, or cognitive conditions make it difficult or impossible for a patient to participate in medical decisions. If your care team has concerns about your ability to make a decision (your decision-making capacity), a physician will assess this.

If you are determined to lack capacity for a specific decision, someone who knows you and cares about you will be asked to make decisions on your behalf. This person is called a surrogate decision-maker or legally authorized representative. The priority order for who serves as surrogate is set by your state’s law and typically goes:

  1. Healthcare proxy or healthcare power of attorney — a person you named in advance in a legal document
  2. Legal guardian (if one has been appointed by a court)
  3. Spouse or domestic partner
  4. Adult children
  5. Parents
  6. Adult siblings
  7. Other close relatives or someone who knows you well

Planning ahead: Advance directives and healthcare proxy

The best time to identify a healthcare proxy — someone you trust to make decisions for you if you ever cannot — is before you need one. An advance directive (also called a living will or healthcare power of attorney) is a legal document that names your proxy and may also record your wishes about specific types of care.

Talk to your family about your wishes. Ask your care team or your hospital’s social worker how to complete an advance directive if you do not have one.

Pediatric patients

If you are a parent or guardian of a minor child receiving vascular access care, you are the decision-maker for your child’s medical care. Your care team should explain everything to you as they would to any adult patient. Depending on the child’s age and maturity, your child may also be asked for their assent (agreement) — even if you, as the parent, are providing formal consent.

Routine Procedures and Verbal Agreement

Not every IV procedure requires a formal written consent form. A standard peripheral IV insertion, for example, is typically covered by the general consent to treatment you sign when admitted to a hospital or clinic. However, your nurse is still required to explain what they are about to do and ask for your agreement before proceeding. You still have the right to decline.

Even for routine procedures, you can always ask:

  • “What are you putting in my IV?”
  • “How long will this infusion take?”
  • “What is this medication for?”
  • “What exactly are you going to do, in simple terms?”
  • “Why do I need this specific type of catheter?”
  • “What are the chances something goes wrong?”
  • “What are my other options?”
  • “What happens if I say no?”
  • “How long will I have this catheter?”
  • “Can I talk to my family before I decide?”
  • “Can I have a copy of this form?”

You are entitled to a copy of any consent form you sign. Keep it for your records.

This guide is for educational purposes and is not a substitute for legal or medical advice. Laws governing informed consent and surrogate decision-making vary by state and jurisdiction. Always consult your care team or a patient advocate if you have concerns about your rights.