Assent vs. Consent?

What is the difference between assent and consent?

Assent and consent both denote an agreement, but how we use them in English varies by context. If you’re giving someone permission from a position of power, “consent” is the correct word to use. But if you’re agreeing with someone or providing approval, “assent” is the way to go. 

Assent vs. consent: Differences in connotation

In addition to having different meanings, how we use assent or consent can imply different tones. According to Garner’s Modern English Usage: 

• Assent suggests “an agreement with an opinion” with more enthusiasm and support.
• Consent “denotes permission to let something happen,” which tends to suggest “mere acquiescence” or reluctance.

With that said, the word assent is becoming less common every year, so you’re more likely to see assent in formal English than casual, everyday conversations (Garner 77). 

Informed assent vs. informed consent?

The last important difference between assent and consent involves their use in health care. 

In general, “informed assent” is one of many ethical principles necessary for clinical research, in which a provider informs a patient of their rights, medical procedure, risks, benefits, and more (don’t worry, we have an entire section below). 

Doctors must provide full context and information about a particular study or procedure before a patient can consent.

Informed assent is essentially the same as informed consent, but there are two important differences: 

1. Consent is only given by someone of legal age or with the legal capacity to do so. 
2. Assent is given by children or individuals who require permission from a legal guardian. 

What does assent mean?

According to the New Oxford American Dictionary, the word assent is a verb and noun referencing “the expression of approval or agreement” or an “official agreement or sanction” (“Assent” 96). 

Example sentences with the noun:

• “Meanwhile, she’s signaling U.S. assent to a system that might allow foreign governments to tax corporate revenue Congress deliberately chose not to tax…” — Wall Street Journal
• “Analysts expect a significant number of users to deny that permission once it requires their assent.” — AP News
• “But if she’s learned anything from her followers, it’s that everyone loves being roasted—the head-nodding assent that yes, you exist, and yes, you were noticed.” — Vogue

Example sentences with the verb:

• “Today, we expect artists to perform a public role, to assent to interviews and magazine profiles in which they explain and justify their work…” — The New York Times
• “… because watching feels like assenting to a fundamental change in the order of right and wrong.” — Los Angeles Times
• “Instagram, WhatsApp, Oculus VR, and dozens of others are breathing life because they assented to Facebook’s acquisition desires.” — Vanity Fair

Synonyms

Noun: 

Acceptance, acquiescence, agreement, appreciation, approbation, approval, commendation, compliance, concurrence, consent, encouragement, endorsement, imprimatur, OK, recognition, respect, signature, support.

Verb: 

Accede to, accept, acquiesce, agree, approve, bless, concur, consent, give one’s blessing to, give one’s stamp/seal of approval to, rubber-stamp, say yes to, subscribe.

Etymology of assent

Assent comes from Middle English via Old French assenter (verb) and assente (noun), based on Latin assentiri, from ad- ‘toward’ +sentire ‘feel, think.’ 

What does consent mean?

Consent is a noun and verb that references the “permission for something to happen” or the “agreement to do something” (often from a position of authority) (“Consent” 370).  

Example sentences with the noun:

• “After the Senate on Sunday night voted to cut off debate, Mr. Toomey on Monday afternoon offered the compromise for unanimous consent on the floor.” — Wall Street Journal
• “This is about a structural failure that allows real-time data on Americans’ movements to exist in the first place and to be used without our knowledge or true consent.” — The New York Times
• “… Barbash says that the producers attempted to “obtain a consent and waiver,” but she refused to sign it, attempting to halt the film’s release in early 2019.” — W Magazine

Example sentences with the verb:

• “Any user interfaces that are designed to hide or gloss over the personal data you’re consenting to share will no longer be allowed.” — Vox
• “… the court had found Spears did not have capacity to consent to medical treatment and is using that as a pretext for a court order taking away her right to give informed consent.” — Los Angeles Times
• “Given Ferrante’s sentiments about the media, it was shocking to me that she even consented.” — Vanity Fair

Synonyms

Noun: 

Accord, agreement, allowance, assent, authorization, clearance, concurrence, granting, permission, sanction, sufferance, warrant.

Verb: 

Abide, accede, accept, acquiesce, agree, allow, approve, assent, comply, concede, concur, conform, give into, give permission for, go along with, sanction, submit, yield.

Etymology of consent

The word consent is Middle English from Old French consente (noun), consentir (verb), from Latin consentire, from con- ‘together’ + sentire ‘feel.’ 

Informed consent vs. informed assent: Is there a difference?

Informed consent and informed assent are legal processes that occur within health care to ensure the rights and safety of providers and patients. Both processes share a common goal of educating a patient or research participant and making sure they understand procedural or research protocols before they agree to participate. 

The process of “informing” occurs between a patient/research participant and a doctor/research representative and typically includes reading, signing, and filing an informed consent or informed assent form. Most times, these forms come in the form of informative packets with an associated waiver. 

Commonalities between informed consent and informed assent include:

• Whoever engages in study or procedure must do so willingly and without coercion or undue influence from the provider.
• For procedures or studies involving more than minimal risk, providers must recommend participants’ involvement and justify their reasoning. 
• Whichever party is legally capable of assent or consent must understand the context of research or general medical care and the patient or research subjects’ rights.

What is informed consent?

Informed consent is a voluntary agreement between a health care/research provider and a patient/research subject. According to the National Center of Biotechnology Information (NCBI), informed consent is “both an ethical and legal obligation of medical practitioners in the US and originates from the patient’s right to direct what happens to their body.”

Within health care, specifically, informed consent is a requirement for any treatment, sharing patient medical history, or when it’s necessary to discuss HIPAA laws. 

As noted by the NCBI, there are five required elements of the informed consent process: 

1. Patients understand the nature of the procedure.
2. Patients are aware of foreseeable risks and benefits of the procedure.
3. Patients understand reasonable alternatives.
4. Patients are aware of foreseeable risks and benefits of alternative procedures. 
5. Health care or research provider must assess the patient’s understanding of the first four elements.

There are exceptions to the informed consent process, including when a patient is incapacitated, experiencing a life-threatening emergency that needs to be treated immediately (there’s no time to waste), or if a patient has voluntarily waived consent. 

If a patient or participant’s mental capacity to make a decision is questionable or unclear, a provider may need to request a psychiatric evaluation before continuing with procedure or research. If a patient cannot make decisions independently, they will need a “designated decision-maker,” such as a parent, legal guardian, or an entity appointed by the court. 

Children (anyone under their state’s legal age) cannot provide informed consent, but their parent or legal representative can permit treatments and interventions as “informed permission.” Exceptions exist for legally emancipated children under 18 and married, serving in the military, financially independent, or for those who have children of their own. 

What is informed assent?

Informed assent is the process of obtaining approval from a child’s legal representative or a “competent child,” meaning they are capable of understanding what they are agreeing to and have the capacity to make informed decisions. 

Informed assent is required anytime a patient or research subject is underage, although the legal age of consent varies by local law. If a child lacks the capacity to understand a procedure, only a parent or legal guardian can provide informed consent on their behalf. 

Doctors are responsible for determining a child’s ability to provide informed assent. Providers determine the capacity of informed assent based on a child’s age, developmental level, maturity, or psychological state.

With that said, any potential subject or patient has the right to receive information regarding treatment or the context of the research. If participating in a treatment or research study is unnecessary (meaning it’s not a matter of saving the child’s life), a child may refuse to participate. 

The only time a provider can bypass the informed assent process is in the event of a medical emergency, and there’s not sufficient time for guardian permission. However, a legal guardian may refuse life-saving treatment from a doctor, depending on the circumstance. 

Additional reading

Looking for similar lessons like assent vs. consent? Then be sure to check out similar articles by The Word Counter, such as: 

• Amount vs. number?
• Between vs. among?
• Titled vs. entitled?
• Translucent vs. transparent?

Test Yourself!

Test how well you understand the difference between assent and consent with the following multiple-choice questions. 

1. True or false?: Consent and assent are legal terms with the same meaning.
   a. True
   b. False
2. __________ suggests “an agreement with an opinion” with more enthusiasm and support.
   a. Consent
   b. Assent
3. __________ “denotes permission to let something happen,” which tends to suggest “mere acquiescence” or reluctance.
   a. Consent
   b. Assent
4. __________ is only given by someone of legal age or with the legal capacity to do so.
   a. Consent
   b. Assent
   c. A or B
   d. All of the above
5. __________ is given by children or individuals who require permission from a legal guardian.
   a. Consent
   b. Assent
   c. A or B
   d. All of the above
6. ___________ is a reasonable requirement for signing a consent form.
   a. A study’s significant new findings
   b. Informed consent
   c. Prospect of direct benefit
   d. Ethical principles
7. An informed consent document must provide ____________.
   a. A description of any benefits
   b. Disclosure of appropriate alternative procedures
   c. The identification of any procedures 
   d. All of the above
8. Which of the following factors do not influence a doctor’s assessment for whether a child can provide informative assent?
   a. Psychological state of the children
   b. Expected duration of the subject’s participation
   c. Applicable law of the jurisdiction
   d. The potential subject’s maturity level
9. A child’s affirmative agreement must involve ___________.
   a. An agreement to cover additional costs
   b. Guidance on how to respond
   c. Willingness
   d. All of the above

Quiz Answers

1. B
2. B
3. B
4. A
5. A
6. 0
7. D
8. B
9. C

Sources

1. “Assent.” Lexico, Oxford University Press, 2021.
2. “Assent.” The New Oxford American Dictionary, 3rd ed., Oxford University Press, 2010, p. 96.
3. Barnhill, T. “Instagram’s Favorite Illustrator Takes On Fashion Week.” Vogue, vogue.com, 6 Sep 2016.
4. Bilton, N. “This is serious: Facebook begins its downward spiral.” Vanity Fair, vanityfair.com, 23 Jan 2018.
5. Caramanica, J. “A team loaded with fierce rivals.” Los Angeles Times, latimes.com, 25 Oct 2009.
6. Dalton, A. “Britney Spears’ father seeks court probe of her conservatorship allegations.” Los Angeles Times, latimes.com, 1 Jul 2021.
7. De Lourdes Levy, Maria et al. “Informed consent/assent in children. Statement of the Ethics Working Group of the Confederation of European Specialists in Paediatrics (CESP).” European Journal of Pediatrics, 19 Jul 2003. 
8. Eckardt, S. “The Hustlers Legal Drama, Explained.” W Magazine, wmagazine.com, 8 Jan 2020. 
9. Editorial Board, The. “A Bipartisan Cryptocurrency Crackup.” Wall Street Journal, wsj.com, 10 Aug 2021.
10. Editorial Board, The. “Congress Goes AWOL on Global Taxation.” Wall Street Journal, wsj.com, 15 Jul 2021.
11. Garner, B. “Assent; consent.”Garner’s Modern American Usage, 3rd ed., Oxford University Press, 2009, p. 77. 
12. “Consent.” Lexico, Oxford University Press, 2021.
13. “Consent.” The Merriam-Webster.com Thesaruas, Merriam-Webster Inc., 2021.
14. “Consent.” The New Oxford American Dictionary, 3rd ed., Oxford University Press, 2010, p. 370.
15. Liedtke, M. “Apple CEO escalates battle with Facebook over online privacy.” AP News, apnews.com, 28 Jan 2021.
16. O’Grady, M. “The Shadows.” The New York Times, nytimes.com, 13 Apr 2020. 
17. Ovide, S. “The Nightmare of Our Snooping Phones.” The New York Times, nytimes.com, 21 Jul 2021.
18. Schappell, E. “Elena Ferrante Didn’t Owe the World Anything.” Vanity Fair, vanityfair.com, 7 Oct 2016.
19. Shah P, Thornton I, Turrin D, et al. “Informed Consent.” StatPearls, Treasure Island StatPearls Publishing, Jan 2021.
20. Tiffany, K. “Some apps use design to trick you into sharing data. A new bill would make that illegal.” Vox, vox.com, 10 Apr 2019.