Capacity Flashcards
Define Consent
permission granted in full knowledge of possible consequences typically given by patient or doctor
State the criteria for valid consent.
- Capacity
- Informed
- Consent voluntarily
- Continuing consent
Outline the difficulties in assessing capacity.
- Changes
- Non-cooperation
- Irrational Decision ≠ Capacity
- Underlying conditions
- Communication problems
What is Proxy Decision-Making?
Someone with capacity to make a decision on behalf of someone else
Give two difficulties of Proxies in Decision-Making.
- Discordant views
* Proxy decisions may not be in the best interest
What is Gillick Competence?
Respect for mature minor’s autonomy provided they have capacity and sufficient maturity to understand what is happening
Outline the Fraser Guidelines.
- U16 Girls have right to contraception and sex provided they are mature
- Cannot persuade to involve parents
- Very likely to continue having sex ± contraception
- Holistic care: Physical, Social and Mental health
- Give contraception in her best interests
State two examples of laws regarding Capacity in the UK
- England + Wales: Mental Capacity Act (2005)
* Scotland: Adults with Incapacity Act (2000)
Describe the major differences in Legislation in England and Wales compared to Scotland regarding Capacity.
- E+W: Assumed to have capacity unless established lacking capacity
- E+W: Must take all practicable steps to help them make a decision
- E+W: Key principle Best Interests
- Scotland: Best Practice/Outcome
What is Capacity?
Ability to understand information and rationalize it, then communicate the decision and hold it, fully knowing the potential consequences
State the criteria for Capacity.
- Understand information
- Retain information
- Critically analyse information
- Communicate decision
- Hold decision
Give the criteria for Incapacity.
- Understand information
- Retain information
- Critically analyse information
- Communicate decision
- Hold decision
Give examples of difficulties in assessing capacity.
- Changes
- Non-cooperation
- Irrational Decision ≠ Capacity
- Underlying conditions
- Communication problems
What way can you circumvent decision-making difficulties should a patient show a lack of Capacity?
Give examples of how this may be enacted.
Proxy Decision-Making
= Someone with capacity to make a decision on behalf of someone else
- Lasting power of attorney
- Advance directives
- Best interest test (HCP, relatives, carers)
Give two difficulties of challenges with proxies.
- Discordant views
* Proxy decisions may not be in the best interest
