Cap Flashcards
Ethical dilemmas can arise …
conflict between the law and what you deem ‘morally right’
Capacity
Capacity is the ability of a person to make decisions that may have consequences for themselves and/or others affected by the decision that person makes.
In healthcare what can impair capacity?
children, adults with learning disabilities, or suffering from certain conditions e.g. dementia can impair capacity
The Mental Capacity Act 2005
Provides the statutory framework to empower and protect vulnerable people who may not be able to make their own decisions particularly about their healthcare (physical and mental), welfare, finances, property and research.
Provides a substitute decision making framework
Mental Cap Act 2005 assumes
adults have mental capacity unless proved otherwise
Individuals have the right to…
make their own decisions (although they may be eccentric or unwise)
Anything done on behalf of people without capacity must be
in their best interests, in a way that respects informed, freely given pt choice
Assessing capacity? Can the person:
- Understand the relevant info
- Retain the information as long as necessary
- Weigh that information up as part of the decision making process
- Communicate their decision
Consent
express a willingness, give permission, agree
Why is consent important?
To maintain a partnership Legal duty (pt have the right to be involved in decisions)
2 Type of consent
Implied
Explicit
Implied consent
Pt indicates their consent indirectly without writing or speaking
Explicit
Pt givens you specific permission to do something (written or verbal)
Is consent valid?
Capacity?
No pressure?
Balanced info?
On each occation
When do pt have the right to withdraw consent
at any time
Concent in children and young adults
should be involved as much as possible in decisions about their care, even when they are not able to make decisions on their own
In an emergency (save life/prevent serious deprivation of health)
treatment without consent can be provided
No one can give consent on your behalf from ….
18 years
For a child to give consent
they mush have ‘capacity’
- if not competent consent must be obtained from someone else
Gillick competency
children can be legally competent if they have sufficient understanding and maturity to enable them to fully understand what is propsed
Under 16? Consent is
- not automatic
- can be legally competent (Gillick)
- capacity for risk free procedures does not mean cap for high risk procedures
- families should be involved if possible
- competent child can insist on confidentility
If parents and child disagree
- Parent cannot override child if they want treatment
2. Child cannot refuse treatment if parents don’t agree
16&17
Presumed consent
families should be encouraged to be involved
Cannot refuse treatment if agreed by person with responsibility
Non-therapeutic procedures?
completely different
Confidentiality
Respect privacy
Obtain only info you need
Document to support confidentiality
NHS Code of practice 2003
Circumstances where information may be disclosed
Consent
Legal obligation
public interest
If disclosing infromation
- try to get the patients consent
- disclose only the information needed for a particular purpose
- make appropriate records
- prepare to justify your actions
types of discloseures
with consent
without consent
required by law
public interest
when can information be disclosed
prevent injury or damage or death
safeguard public health
prevent/detect crime
Out professional responsibilities… 7
Respect a patient’s right to expect confidentiality
Record info accurately and consistently
Keep patient information private
Keep patient information secure
Only disclose info with appropriate care in line with legal and professional guidance
Ensure patient choice is respected
Inform patient effectively about shared info
