Capacity and Consent

Question 1

What is need for consent to be valid?

Answer 1

Mus be given freely without coercion
Person must be legally able to consent
The consent must be informed and enduring

Question 2

What must be considered before obtaining consent?

Answer 2

What the treatment consists of
Main beneficial effects of the treatment
Risks and side effects of treatment

Question 3

What must someone have in order to be judged to have capacity?

Answer 3

Must understand and retain information
Use and weigh that information to make a decision
Must be able to communicate their decision

Question 4

Is capacity universal across all settings?

Answer 4

No = a person may have capacity for one decision but not another

Question 5

What people are covered under the Adults with Incapacity act?

Answer 5

Those who are incapable of acting, making/communicating/understanding decisions and communicating their decision

Question 6

What is the Adults with Incapacity act in relation to?

Answer 6

Any particular matter by reason of mental disorder or of inability to communicate because of physical disability

Question 7

What are the principles of the Adults with Incapacity act?

Answer 7

Interventions must benefit adult
Such benefit can’t reasonably be achieved without the intervention
Take account of past and present wishes
Consult with other relevant persons
Encourage the adult to use residual capacity

Question 8

What is the section 47 certificate of the Adults with Incapacity act?

Answer 8

Authorises practitioner to provide reasonable interventions related to treatment authorised

Question 9

What does the section 47 certificate of the Adults with Incapacity act not authorise?

Answer 9

Force = unless immediately necessary and only for as long as necessary
Transport of adult to place of treatment

Question 10

What is power of attorney?

Answer 10

Power to act as patient’s continuing financial and/or welfare attorney = granted whilst patient has capacity, may be more than one person

Question 11

What are some features of guardianship?

Answer 11

Applied for by one or more people, or local authority
Granted by sheriff
For when person needs someone to make decisions on their behalf over long term

Question 12

What ability does the power of welfare guardian not have?

Answer 12

Can’t place the adult in hospital for treatment of mental disorder against their will

Question 13

What happens if the patient doesn’t comply with the wishes of their power of welfare guardian?

Answer 13

There is a mechanism in place for the sheriff to issue a compliance order

Question 14

What does the Mental Health act allow?

Answer 14

Treatment of mental disorder or physical consequences of mental disorder in someone without capacity for consent

Question 15

What is the criteria for emergency detention?

Answer 15

Likely to have mental disorder
Significantly impaired decision making ability regarding treatment due to mental disorder
Detention is necessary as a matter of urgency to determine what treatment is needed
Risk to health, safety and welfare of patient/others
Making arrangements for short term detention would involve undesirable delay

Question 16

What is the criteria for short term detention?

Answer 16

Likely to have mental disorder
Significantly impaired decision making ability regarding treatment due to mental disorder
Detention is necessary for assessment or treatment
Risk to health, safety or welfare of patient/others
Can’t be treated voluntarily

Question 17

What are some features of consent as it relates to children and adolescents?

Answer 17

Try to involve children and young people as much as possible
Presumed to capacity to make most decisions about treatment and care by age 16

Question 18

Wat is needed for a young person to be judged to have capacity?

Answer 18

Understand nature, purpose and possible consequences of treatments
Understand consequences of not having treatment
Understand, retain and use this info, and communicate this decision
Encourage parental involvement

Question 19

What covers incapacity in children?

Answer 19

The Children act = ask one parent for consent if young person lacks capacity, seek legal advice if parents disagree

Question 20

When should you consider the Mental Health act when dealing with children or young people?

Answer 20

Use of force and intramuscular treatment
Certain treatments (e.g nasogastric feeding)
If there would be a detrimental impact on relationship between patient and carer