Capacity and consent

Question 1

What are the 4 principles of bioethics

Answer 1

Autonomy, beneficence, non-maleficence, justice.

Question 2

What is autonomy

Answer 2

Respect for the individual and ability to make decisions about their own health

Question 3

What is beneficence

Answer 3

Acting to the benefit of patients

Question 4

What is non-maleficence?

Answer 4

Acting to prevent harm to patients

Question 5

What is justice?

Answer 5

Fairness to patients and community in considering the consequences of an action.

Question 6

What is capacity?

Answer 6

The ability to use and understand information to make a decision and communicate any decision made

Question 7

How to determine capacity?

Answer 7

Understand information and consequences of refusal.
Retain information to make decision.
Weigh up information.
Communicate decision.

Question 8

What is mental capacity act 2005

Answer 8

• Presumption of capacity.
• Individuals should be helped to make their own decisions.
• Individuals retain right to make eccentric or unwise decisions.
• Anything done of behalf of people without capacity must be in best interests.
• Least restrictive intervention.

Question 9

What to consider for best interests?

Answer 9

-Involve patient
- Advance decision
- Lasting power of attorney
- Friends/family
- Religion
- Can we wait?

Question 10

What is advance decision?

Answer 10

A decision to refuse specific type of treatment at some time in future.

Question 11

What is advance statement?

Answer 11

A written statement which sets down preferences, wishes, beliefs and values regarding future care. NOT legally binding.

Question 12

What is lasting power of attorney?

Answer 12

A legal document that lets the ‘donor’ appoint one or more people (attorneys) to help them make decisions or to make decisions on their behalf.

Question 13

What to do in serious doubt?

Answer 13

Treat patient under doctrine of necessity.

Question 14

What are the types of consent?

Answer 14

• Implied
• Expressed: verbal or written

Question 15

7 principles of decision making and consent

Answer 15

• All patients have right to be involved in decisions about treatment.
• Decision making is ongoing process of exchange of relevant information.
• All patients have right to be listened to, and be given info.
• Must find out what matters to patients, alternatives must be explored.
• Start with presumption that all adults have capacity.
• Decisions where there is no capacity should be in best interests.
• Patients whose right to consent is affected by law should be supported to be involved in decision making process.

Question 16

Age for consent

Answer 16

> 16 are entitled to consent to own treatment.
<16 can consent is they have enough intelligence, competence and understanding.

Question 17

What is the Gillick test

Answer 17

• Demonstrate sufficient understanding and knowledge of treatment and processes it involves, awareness of benefits and risks, and alternatives.
• Medics should rule out any undue influence in pursuing said treatment.