Consent 1 Flashcards
What is consent?
More than a simple agreement to treatment. An ongoing process. Discussion about proposed treatment between patient and health professional and the consequences of treatment and non-treatment.
What are the ethical elements of consent?
Autonomy and non-maleficence or beneficience
What is autonomy?
Where people have the right to be self-governing and have the control to make decisions that concern bodily integrity.
Limits to autonomy
The extent to which an autonomous decision will infringe on the autonomy of other people
What is non-maleficence?
An obligation to not inflict harm on others
What is beneficence?
The moral obligation to act for the benefit of others.
What do non-maleficence and beneficence mean together?
To act in the best interests of the patient
What are the 4 elements of consent?
Competence, information, voluntariness, decision
Competence aspect of consent
The decision making capacity. It is specific to the decision being made. Competent people can become incompetent, e.g. fear, pain. Distinguish between competence and rationality.
Information element of consent
Balance between too much or too little. Explain reasons for treatment, risks and benefits of proposed treatment, consequences of not having treatment, other alternatives and cost.
Voluntariness aspect of consent
Patient must freely agree to treatment without coercion by the dentist/health professional or by family. Persuasion means giving all the facts and being honest about options but believing one treatment is better than others.
Decision element of consent
The patient must make the decision. Consent or refuse to consent and valid refusal should be respected. Consent may be withdrawn at any time.
What is a material risk?
The test of materiality is whether in the circumstance of the Montgomery, a reasonable person in the patients position would be likely to attach significance to the risk, or the clinical is or should reasonable be aware that the particularly patient would be likely attached to it.
What is medical paternalism?
When professionals act on what they thing is best for the patient without having due regard for the patients own choice. Overrides autonomy (conflicts with beneficence). Patients are competent but practitioner overrules their wishes.
What are the legal aspects of consent?
Autonomy is not fully legally protected
Common Law gives partial protection
Rules which protect bodily integrity (battery)
Rules which govern professional competence (negligence)
