Consent Flashcards
1
Q
Consent
A
Patients have a fundamental legal and ethical right to make their own decisions; when applied to a patient’s agreement for a health professional to provide care this is termed consent.
2
Q
Informed consent
A
Permission granted in full knowledge of the consequences
3
Q
Valid consent
A
- Be competent to take a particular decision
- Received sufficient information
- Not acting under duress
4
Q
Explicit consent
A
- Articulated agreement
- Clear and voluntary indication of preference of choice
- Orally/writing
5
Q
Implied consent
A
- Agreement that has been signalled by the behaviour of an individual
- Discussion had been held about issues
- e.g. patient rolls up sleeve and offers arm
6
Q
Legal issues
A
- Consent should be obtained before you examine, treat or care for a competent adult
- Adults are always assumed to be competent to give consent unless demonstrated otherwise
- Giving and obtaining consent is usually a process and not a one off event
- A patient can withdraw consent at any time
- Always best for the person actually treating the patient to seek the patient’s consent
- Patient needs sufficient information
- Consent must always be given voluntarily
- Consent can be written, verbal or non-verbal
- No-one can give consent for another adult
7
Q
Sufficient information for a procedure
A
- A description of the procedure to be undertaken
- Any uncertainties about the effectiveness of the procedure
- The benefits of the procedure
- The risks of the procedure
- Alternative treatments available with risks, burdens and benefits including the do nothing option
8
Q
Delegated consent
A
- Consent taken for a procedure by someone not competent to carry out the procedure
- NHS Litigation Authority see this as a big patient safety issue
9
Q
Mental Capacity Act 2005
A
- Puts current best practice and common-law into a legal framework
- Puts the needs and wishes of a person who lacks capacity at the centre of any decision-making
- Replaces enduring power of attorney with a wider-reaching lasting power of attorney
Reforms the Court of Protection (New Court of Protection) - Creates Independent Mental Capacity Advocacy (IMCA) Services to assist decision making for vulnerable unsupported adults in relation to serious medical treatment or placement in long-term care
- Gives legal authorisation to the advanced refusal of treatment
- Regulates the involvement of incapacitated adults in research
- Creates a new criminal offence of wilful neglect or ill treatment of a person lacking capacity
- Does not alter existing legal tests of capacity
10
Q
Who will be affected by MCA
A
- Dementia
- Learning disabilities
- Brain injury
- Severe mental health problems
- Planning for the future
- Patients with temporary loss of capacity e.g. unconscious, delirium
11
Q
5 principles of MCA
A
- Presumption of capacity
- Supported participation in decision-making
- A right to make unwise/eccentric decisions
- Best interest
- Least restrictive alternative
12
Q
Incapacity
A
Fail to
- Absorb basic information about the pros and cons of an issue or decision
- Retain the information for long enough to process it
- Use or weigh up the information
- Communicate the decision by any means
13
Q
Stage 1 Assessing Capacity
A
- Impairment/disturbance in functioning of person’s mind/brain
- Can be permanent/temporary
- Due to person’s behaviour, circumstances, concerns raised by somebody else
14
Q
Stage 2 Assessing Capacity
A
After been given appropriate help cannot - Understand the information - Retain the information - Make and communicate a decision (they lack capacity)
15
Q
MCA - Public bodies supporting the statutory framework
A
- New Court of Protection (implementation of the legislation, final arbiter in relation to decision-making under the act)
- New Public Guardian (responsible for registration/fee and supervision of lasting power of attorney and court-appointed deputies)
16
Q
Lasting Power of Attorney
A
- Nominated to act on behalf
- Must be registered with New Public Guardian
- Includes decisions about finance, health and welfare
- Doesn’t include decisions about withholding life-saving treatments unless specifically stated
- If doctor is concerned can be referred to New Court of Protection
17
Q
Court-appointed Deputies
A
- The Court of Protection can appoint deputies to makes decisions on welfare, health and finance
- Cannot override an LPA/refuse life-sustaining treatments
18
Q
Independent Mental Capacity Advocate
A
- If a person doesn’t have capacity, a LPA or a court deputy
- Provided by local authority
- Represent and support individual make sure act is followed - assist doctor
19
Q
Role of IMCA
A
- Support
- Obtain and evaluate relevant information
- Person’s wishes and values
- Report to decision-maker
20
Q
Advance Directives (living will)
A
- Decision made to apply to circumstances where competence is lost in future
- Only relates to refusal of treatment
- Oral/written (except refusal of life saving treatment)
- Cannot refuse basic treatment
- Can request specific treatment (not always followed)
21
Q
Refuse of life saving treatment must:
A
- Be in writing
- Be signed and witnessed
- The treatment refused must be specific
- It must be clear that the decision stands even if life is at risk
- The AD must be valid at the time and applicable to the circumstances
22
Q
Section 6 of MCA
A
Permits restraint/deprivation of liberty when
- necessary to prevent harm
- proportionate to the likelihood and seriousness of harm
- for convenience of carers
23
Q
Ill treatment/neglect
A
Maximum 5 years in prison
