Consent

Question 1

Give four important aspects to understanding what consent is:

Answer 1

Patients voluntary agreement to treatment, examinations or other aspects of health care

Patient’s permission to examine, investigate or treat them

“Giving up of right to bodily integrity”

Patient’s understanding that informed consent is ongoing process - can change or revoke at any time

Question 2

What are three charges that could be levelled at a doctor in extreme legal circumstances:

Answer 2

Battery

Negligence

Assault (Criminal charge only)

Question 3

What four key aspects make consent valid?

Answer 3

1. Information
2. Voluntariness
3. Competence
4. Continuing (right to change their minds)

Question 4

What must patients be able to with medical information for them to be deemed competent?

Answer 4

• Understand the information
• Retain it
• Weight up the info
• Communicate decisions

Not all or nothing - task specific, and can alter over time

Question 5

True or False: An unwise or illogical decision from the patient is legally deemed an incompetent decision.

Answer 5

False: For reasons of patient autonomy - may be socio-cultural, religious, or other reasons that may clash with the best medical course of action.

Question 6

Explain the PARQ acronym of medical information being given:

Answer 6

Procedure

Alternatives

Risks

Questions

Question 7

What are the three standards of Adequate Information?

Give example quotaions of each from a medical body.

Answer 7

Professional practice standard – conforms to professional practice

Reasonable/ prudent person standard - hypothetical reasonable person

Subjective standard - enables individual to make informed choice

Question 8

Give a quotated outline of the Bolam test:

Answer 8

Question 9

What are 3 key aspects of Voluntariness?

Answer 9

Patient must be able to refuse

Patient must know they are able to refuse

Patient must be free from undue pressure or coercion

Question 10

True or False: Signed consent forms are proof of informed consent

Answer 10

False: The forms only provide minimal evidence that consent took place, FULL PHYSICIAN NOTES are a far more legally sound.

Question 11

What was the summative ruling of the Montgomery case? And how does it affect the previous use of the Bolam Test?

Answer 11

• “The doctor is under a duty to take reasonable care to ensure that the patient is aware of any ‘material’ risks involved in proposed treatment, and of reasonable alternatives.”*
• A risk is “material” if a reasonable person in the patient’s position would be likely to attach significance to it, or if the doctor is or should reasonably be aware that their patient would be likely to attach significance to it.*

This contrasts heavily with the previous Bolam test, insofar as a reasonable expection of a patient’s perspective and agenda is given higher status than the expected and endemic behaviour of health professionals - regardless of its wider validity.

Question 12

Give three scenarios in which informed consent may be unattainable from a patient:

Answer 12

Not competent

Pose serious risk to others or restrained

Declines all info

Question 13

Give four common issues regarding the obtaining of consent:

Answer 13

Presentation of information

Complexity of information

Time consuming

Effects of fear illness, social status of doctor etc.