11. CONSENT Flashcards
1
Q
- What is Consent?
A
- it is the permission to do something
2
Q
- What is Consent in terms of Health Care?
A
- it is the voluntary agreement to treatment,
examinations or other aspects of Health Care
3
Q
- What is the ethical cornerstone of all Medical Interventions?
A
- Consent
4
Q
- What is a Paternalistic approach?
A
- this was an approach that was very popular in the past
- it is a situation in which the doctor makes the sole
decision about the patient’s treatment - the patient then just agrees
5
Q
- What are the benefits of a Patient-centred approach?
A
- respect of patient autonomy
- primary of consent
6
Q
- What does the WMA Declaration on the rights of the patients state?
A
- the patient has a right to self-determination
7
Q
- What is meant by the right to Self-determination?
A
- the patient has the right to make free decisions
regarding themselves - the physician must inform the patient of the
consequences of their decisions
8
Q
- What does a mentally competent adult have the right to do?
A
- they have the right to give or withhold consent to any
diagnostic procedure - the patient has the right to access all the information
necessary to make their decision - the patient should understand clearly what is the
purpose of their treatment and tests - the patient should understand clearly what the result
of the treatment would be - the patient should understand clearly what the
implications of withholding consent are
9
Q
- What does the patient have the right to refuse?
A
- the patient has the right to refuse to participate in
research - they have the right to refuse to be a part of the training
of medicine
10
Q
- What does the term: “consent” imply?
A
- it is the waiving of our rights
- it is permitting others to do things that they would
otherwise not be allowed to do
11
Q
- What are the aspects of informed consent in Medicine?
A
- the acceptance of treatment
- the choice amongst possible treatments
- the refusal of treatment
12
Q
- Read through this case.
Should the operation go ahead?
A
- NO
- the patient does not realise what she has given
permission for - the consent given by the patient is not valid
- the patient did not have all the necessary information
when she gave her consent - the patient did not understand the information given
13
Q
- List 3 points that are necessary for consent to be valid.
A
- The consent has to be given by a patient who has the
capacity to make decisions about their care - The consent had to be voluntary
- it has to be free from pressure, coercion or
persuasion
- it has to be free from pressure, coercion or
- The patient has to be sufficiently informed before
they give consent
14
Q
- What are the 3 aspects of Informed Consent?
A
- Competence
- Voluntariness
- Information
15
Q
- What does the P in PARQ stand for?
A
- P= PROCEDURE
- what is the procedure for?
- what does the procedure entail?
- what will the procedure feel like?
- what is the nature and the purpose of the treatment
16
Q
- What does the A in PARQ stand for?
A
- A= ALTERNATIVES
- no alternatives can also be included in this
17
Q
- What does the R in PARQ stand for?
A
- R= RISKS
- these are the risks of the procedure / treatment
- it includes the risk of doing nothing
NB:
- this will also outline the Benefits
18
Q
- What does the Q in PARQ stand for?
A
- Q= QUESTIONS
- this includes checking the patient’s understanding
19
Q
- According to Professional Guidance, how should a medical practitioner go about discussing the risks of the treatment with a patient?
A
- clear and accurate information should be presented to
the patient about the risks - present the information in a way patients can
understand - identify the adverse outcomes
- outline the potential outcome of taking no action
20
Q
- List 3 forms of risks?
A
- Side Effects
- Complications
- Failure of an intervention to achieve the desired aim
21
Q
- What are the first 3 steps of the GMC Guidance when it comes to seeking consent?
A
- THE DIAGNOSIS
- and the prognosis - ANY UNCERTAINTIES ABOUT THE DIAGNOSIS OR
PROGNOSIS- include options for further investigations
- OPTIONS FOR TREATING OR MANAGING THE
CONDITION- this includes the option to not treat the patient
22
Q
- What are the next 3 steps (4-6) of the GMC Guidance when it comes to seeking consent?
A
- THE PURPOSE OF ANY PROPOSED INVESTIGATION OR
TREATMENT
- outlines what it will involve - THE POTENTIAL BENEFITS, RISKS AND BURDENS
- as well as the likelihood of success for each option
- should be included in the information given to the
patient - it should also be outlined whether the benefits and
risks of the treatment are affected by the doctor or
organisation providing the care
- WHETHER A PROPOSED INVESTIGATION OR
TREATMENT IS PART OF A RESEARCH PROGRAMME- or if there is an innovative treatment designed
specifically for the benefit of the patient
- or if there is an innovative treatment designed
23
Q
- What are the next 3 steps (7-9) of the GMC Guidance when it comes to seeking consent?
A
- THE PEOPLE WHO WILL BE MAINLY RESPONSIBLE FOR
THE PATIENT
- as well as the people involved in the care of the
patient
- what their roles are
- to which extent medical students can be involved - THE PATIENTS RIGHT TO REFUSE
- to take part in teaching or research
- THE PATIENT’S RIGHT TO SEEK A SECOND OPINION
24
Q
- What are the next 3 steps (10-12) of the GMC Guidance when it comes to seeking consent?
A
- THE PATIENT’S BILLS
- that they have to pay
- ANY CONFLICTS OF INTEREST
- that you, the organisation and the patient may have
- ANY TREATMENTS FROM ANOTHER SOURCE THAT
YOU BELIEVE HAVE GREATER POTENTIAL BENEFIT- for the patient
- than what you or your organisation can offer
25
Q
- What is one aspect that is necessary for Consent to be valid?
A
- it has to be continuous
26
Q
- What are the 2 aspects of Continuous Consent?
A
- THE PATIENT SHOULD BE INFORMED
- that they can change their mind at any time - CONSENT SHOULD BE REPEATEDLY GAINED
- in the course of the consultation
- and in relation to specific procedures
- EG: physical examinations or blood examinations
27
Q
- What are the 2 types of Consent?
A
- Explicit
- Implied
28
Q
- What is Explicit Consent?
A
- this is also known as Expressed Consent
- it is consent that is given when a patient actively agrees
to the use or disclosure of information - the patient expressed verbal consent
- the patient expressed written consent
29
Q
- What is Implied Consent?
A
- this is the consent that refers to circumstances in
which it would be reasonable to infer that the patient
agrees to the use of information - even though the patient has not directly expressed this
30
Q
30.Does consent always have to be written down?
A
- NO
- but this documentation may provide evidence of the
consent process
31
Q
- Read through this case.
What should have been done in this situation?
A
- the doctor needed to ask if the patient is okay with this
- the doctor needed to introduce the Medical students
to the patient - the doctor needed to ask if there are any limitations
that the patient might have in this situation
32
Q
- What is necessary when it comes to the consent of the patient and Medical Students?
A
- we have to seek consent from the patients to
participate in the teaching or training that is essential
in Clinical Education - this consent follows the same principles as seeking
consent for treatment
