Chapter 8 - Consent to Treatment

Question 1

advance directive

Answer 1

A legal document that states a person’s wishes about receiving medical care if that person is no longer able to make medical decisions because of a serious illness or injury.

Question 2

age of majority

Answer 2

The threshold of adulthood as recognized or declared in law. It is the moment when minors cease to be considered minors and assume legal control over their persons, actions, and decisions, thus terminating the control and legal responsibilities of their parents or guardian over them.

Question 3

agent (law)

Answer 3

A person who has been legally empowered to act on behalf of another person or an entity

Question 4

durable power of attorney (DPOA)

Answer 4

A Durable Power of Attorney may be the most important of all legal documents. This legal document gives another person the right to do certain things for the maker of the Durable Power of Attorney. What those things are depends upon what the Durable Power of Attorney says. A person giving a Durable Power of Attorney can make it very broad or can limit the Durable Power of Attorney to certain acts. A Durable Power of Attorney is valid even when the person creating it becomes incapacitated.

Question 5

express consent

Answer 5

A clear and direct statement of agreement. If you have ever participated in a research study, you have probably given your express consent for your information to be used by researchers. When you sign paperwork for a dental cleaning, it probably includes an express consent to that type of treatment.

Question 6

Federal Policy for the Protection of Human Subjects

Answer 6

a law that protects the rights and welfare of human beings who participate in research as the subjects of that research

Question 7

general consent form

Answer 7

documentation of an agreement from an individual or the individual’s representative to receive physical health services to address the individual’s medical condition or behavioral health services to address the individual’s behavioral health issues

Question 8

implied consent

Answer 8

Consent which is not expressly granted by a person, but rather implicitly granted by a person’s actions and the facts and circumstances of a particular situation (or in some cases, by a person’s silence or inaction). For example, if a person is unconscious as a result of injuries sustained during a traffic collision, medical treatment may be provided to that person, despite the unconscious person being unable to expressly grant consent for that treatment.

Question 9

informed consent

Answer 9

A detailed process for getting permission before conducting a healthcare intervention on a person, for conducting some form of research on a person, or for disclosing a person’s information. The following are the required elements for documentation of the informed consent discussion: (1) the nature of the procedure, (2) the risks and benefits and the procedure, (3) reasonable alternatives, (4) risks and benefits of alternatives, and (5) assessment of the patient’s understanding of elements 1 through 4.

Question 10

institutional review board (IRB)

Answer 10

an administrative body established to protect the rights and welfare of human research subjects recruited to participate in research activities conducted under the auspices of the institution with which it is affiliated

Question 11

living will

Answer 11

a legal document that specifies the type of medical care that an individual does or does not want in the event they are unable to communicate their wishes

Question 12

long form

Answer 12

longer than usual and dealing with subject in depth

Question 13

National Research Act of 1974

Answer 13

a federal law responsible for creating the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research

Question 14

non compos mentis

Answer 14

Latin for “not of sound mind”

Question 15

Patient Self-Determination Act (PSDA)

Answer 15

a federal law that works to ensure that a patient’s right to self-determination in health care decisions be communicated and protected

Question 16

power of attorney (POA)

Answer 16

a legal document giving one person (the agent or attorney-in-fact) the power to act for another person (the principal); its authority ends when a person is incapacitated, unlike the DURABLE power of attorney

Question 17

therapeutic privilege

Answer 17

an uncommon situation whereby a physician may be excused from revealing information to a patient when disclosing it would pose a serious psychological threat, so serious a threat as to be medically contraindicated

Question 18

Uniform Anatomical Gift Act (UAGA)

Answer 18

a law that creates a regulatory framework for the donation of organs, tissues, and other human body parts in the US

Question 19

indemnify (verb)

Answer 19

(1) to secure against hurt, loss, or damage

(2) to make compensation to for incurred hurt, loss, or damage

Question 20

auspice(s)

Answer 20

(1) kindly patronage and guidance
(2) a prophetic sign
(3) observation by an augur especially of the flight and feeding of birds to discover omens

Question 21

augur

Answer 21

(1) an official diviner of ancient Rome

(2) one held to foretell events by omens

Question 22

divination

Answer 22

the art or practice that seeks to foresee or foretell future events or discover hidden knowledge usually by the interpretation of omens or by the aid of supernatural powers; one who practices divination is a diviner

Question 23

contraindication

Answer 23

a condition that serves as a reason not to take a certain medical treatment due to the harm that it would cause the patient

Question 24

indication

Answer 24

a valid reason to use a certain test, medication, procedure, or surgery

Question 25

omnibus

Answer 25

(1) a usually automotive public vehicle designed to carry a large number of passengers
(2) a book containing reprints of a number of works (as of a single author or on a single subject)

Question 26

springing power of attorney (springing POA)

Answer 26

a durable power of attorney that is only enforced when the creator is incapacitated

Question 27

decedent

Answer 27

a legal term used by professionals in the tax, estate planning, and law fields for a deceased person

Question 28

guardian ad litem

Answer 28

a guardian that a court appoints to watch after someone during a case

Question 29

persistent vegetative state

Answer 29

also called post-coma unresponsiveness; a disorder of consciousness in which patients with severe brain damage are in a state of partial arousal rather than true awareness. After four weeks in a vegetative state (VS), the patient is classified as in a persistent vegetative state. This diagnosis is classified as a permanent vegetative state some months (three in the US and six in the UK) after a non-traumatic brain injury or one year after a traumatic injury. The term “unresponsive wakefulness syndrome” is alternatively used, as “vegetative state” has some negative connotations among the public.

Question 30

materiality

Answer 30

quantitative and qualitative omissions or misstatements that make it probable the judgement of a reasonable person would have been changed or influenced

Question 31

lucidity

Answer 31

(1) clearness of thought or style

2) a presumed capacity to perceive the truth directly and instantaneously (i.e. clairvoyance

Question 32

rotator cuff

Answer 32

a group of muscles and tendons that surround the shoulder joint, keeping the head of your upper arm bone firmly within the shallow socket of the shoulder

Question 33

capacity

Answer 33

a measure of the individual’s mental competence

Question 34

waiver

Answer 34

the act of intentionally relinquishing or abandoning a known right, claim, or privilege

Question 35

tubal ligation

Answer 35

An operation to tie the fallopian tubes closed. This procedure prevents pregnancy by blocking the passage of eggs from the ovaries to the uterus.

Question 36

intervention (medical)

Answer 36

a treatment, procedure, or other action taken to prevent or treat disease, or improve health in other ways

Question 37

competent adult

Answer 37

an individual who is mentally capable and is at or above the age of majority

Question 38

incompetent adult

Answer 38

an individual who is at or above the age of majority but is incapacitated due to illness or injury, either permanently or temporarily

Question 39

terminal lucidity

Answer 39

an unexpected return of mental clarity and memory, or suddenly regained consciousness that occurs in the time shortly before death in patients

Question 40

durable power of attorney for healthcare decisions (DPOA-HCD)

Answer 40

a durable power of attorney written specifically for healthcare decisions

Question 41

do not resuscitate (DNR) order

Answer 41

a specific type of advance directive in which an individual states that healthcare providers should not perform CPR if the individual experiences cardiac arrest or cessation of breathing

Question 42

fallopian tubes

Answer 42

One of two long, slender tubes that connect the ovaries to the uterus. Eggs pass from the ovaries, through the fallopian tubes, to the uterus.

Question 43

clairvoyance

Answer 43

(1) the power or faculty of discerning objects not present to the senses
(2) ability to perceive matters beyond the range of ordinary perception

Question 44

short form vs long form

human subjects research context

Answer 44

Both are written consent forms.
Both follow the requirements of the Common Rule.
Both can be used for either medical research or medical interventions.
The short form is a simpler, shorter consent form usually dealing with consent for medical interventions or medical research that are less risky, invasive, or experimental.
The long form is a longer, more complex consent form that deals with high risk medical interventions or medical research.

Question 45

Common Rule

Answer 45

a 1981 rule of ethics in the United States regarding biomedical and behavioral research involving human subjects