Capacity and Consent

Question 1

what is capacity

Answer 1

person’s ability to do something, including making a decision, which may have legal consequences for the person themselves or other people.

Question 2

what way can we assess capacity to consent to treatment in a patient

Answer 2

• understand what the treatment is, its purpose and nature and why it is being done
• understand the benefits, risk and alternatives
• understand the consequences of NOT having the Tx
• retain info long enough to use it and balance it to arrive at a decision

Question 3

what does the Adults with Incapacity Act provide

Answer 3

framework for safeguarding the welfare and managing the finances of adults (>16y/o) who lack capacity due to mental illness, learning disability or a related condition, or an inability to communicate.

Question 4

what is power of attorney

Answer 4

authority given by an individual with capacity (known as the Granter) to another person(s) (known as the Attorney/s) to deal with aspects of the Granter’s affairs

Question 5

what is meant by incapable

Answer 5

a lack of capacity to

• make decisions
• understand decisions
• communicate decisions
• act on decisions
• retain the memory of decisions

Question 6

what does section 47 prohibit

Answer 6

use of force or detention unless it is immediately necessary and only for as long as is necessary

Question 7

what does Article 5 of the European Convention on Human Rights protect patients against

Answer 7

arbitrary detention

Question 8

what criteria does someone need to have meet to be detained under the Mental Health Act

Answer 8

• have a diagnosed Mental Disorder
• Significantly impaired decision making ability
• Risk to self or others
• Less restrictive alternatives not appropriate
• Necessary
• Treatment is available

Question 9

what are the rules for children and consent

Answer 9

Under 12 years presumed not to have capacity

Under 16 may have capacity to decide depending on their level of understanding

Over 16 assumed to have capacity

Question 10

what needs to be shown to assume a child between 12-16 have consent

Answer 10

Need to understand nature, purpose and consequence of intervention

Need to understand consequences of not having intervention

Question 11

can a parents over rule a competent child

Answer 11

NO

- parents can seek legal advice but cannot force child to do anything

Question 12

what is common law

Answer 12

giving treatment without consent as it cannot be given to save a life or prevent deterioration in health

Question 13

what is one of the rules of common law

Answer 13

not doing anything a Doctor of you training is not trained to do i.e. act within your abilities.

Question 14

what are the 3 lengths someone can be detained under the Mental Health Act

Answer 14

Emergency - up to 72 hours

Short Term - up to 28 days

CTO - up to 6 months

Question 15

how does the Scottish Mental Health Act apply too

Answer 15

person with:

• any mental illness
• learning disability
• personality disorder

Question 16

what is an emergency detention

Answer 16

where it is necessary as a matter of urgency to detain the patient in hospital for the purpose of permitting a full assessment of the person’s mental state; and where if the patient were not detained in hospital there would be a significant risk to either themselves or others

Question 17

who needs to sign off on an emergency detention

Answer 17

Registered medical practitioner

Usually with the consent of a Mental Health Officer (but can proceed without if urgent)

Question 18

what is the criteria for an emergency detention

Answer 18

max of 72 hours

Must be likely that the patient has a mental disorder

Patient’s ability to make decisions about medical treatment for mental disorder must be significantly impaired

No alternative to treatment in hospital required urgently

Short term detention impractical

Question 19

what are features of the short term detention

Answer 19

Authorises treatment

Lasts for maximum of 28 days

Right of appeal to Tribunal and Mental Welfare Commission

Question 20

what is the criteria for applying short term detention

Answer 20

patient has mental disorder

patient’s ability to make decisions about the provision of medical treatment is significantly impaired as a result of that mental disorder

necessary to detain the patient in hospital for the purpose of determining what medical treatment should be given to the patient or of giving them medical treatment

There would be a significant risk to the health, safety or welfare of the patient or to the safety of any other person if the patient were not detained in hospital

Question 21

what is the features of the compulsory treatment order

Answer 21

Right of appeal, may have legal representation

Authorises treatment

Requires to have tribunal hearing

Care Plan prepared by MHO can impose conditions ie residency, attendance at services

Last for up to 6 months

Patient can be in hospital or community