Consent Flashcards
What are the 4 principles of ethics
Autonomy (confidentiality, consent, capacity)
Non-malfeasance
Beneficence
Justice (non-discriminant)
What is a duty of candour
Open and honest when something goes wrong and apologise
Take part in investigations
Explain short + long-term effects
Seek seniors advice if unsure
Raise concerns if best interests compromised
What should you always do as a doctor
Non-judgemental Personal views not important - fair presentation of facts, refer Confidentiality Don't exceed competency Fitness to practise - raise concerns Patient best interest
What are types of consent
Implied
Verbal
Written
Rational - give patient enough info to make decision
What is consent
An adult of sound mind has right to determine what is done with body
Must be capable of understanding info given
What is negligence
Requires a failure in duty and causation (foreseeable damage)
What is the consent law
Cannot perform operation for no good reason, even if there is consent
When can you not gain consent
Unconscious
No capacity
Expediency
Cannot communicate
What does consent process involve
Competency test Examination Differential Treatment plan / alternatives Risks and benefits of Rx and no Rx
What law does Scotland have for no capacity
Adults with Incapacity Act
What is Gilick Competent
Children >12 <16 can consent if they understand options and risks + benefits
Cannot be overridden by parents but can be by court
What is an advance directive
Adults with capacity can make an advanced directive refusing treatment when they lack capacity
Invalid if evidence they have changed their mind, reason to doubt authenticity, not specific to treatment proposed
Doctors can act in best interest if not satisfied it is valid
In regards to adults with incapacity how do you determine whether intervention should be made
Present and past wishes acknowledge
Views of nearest relative
Views of guardian / POA
What is the court powers
Determine whether info is released to nearest relative
Appoint nearest relative
What is the public guardian
Sets up and manages power of attorney
Holds and maintain documents relating to cases
Consult mental welfare commission
What is the mental welfare commision
Protective functions on personal welfare of an adult
What is a continuing POA
Finance and property
What is a welfare POA
Personal welfare
How is a POA established
Written when person has clear capacity
No unsure duress
Granter understands nature and power
What role does a doctor have in treating someone who can’t consent
Investigate competency
Think best interest
Authority to treat if to safeguard / best interest
Cannot carry out if intervention / guardianship order unless authorised
Can intervene to save life if cannot contact
Can you carry out research on someone unable to consent
No unless purpose is to obtain knowledge of causes / Rx
When does a person lack capacity
Cannot understand info
Unable to retain info
Cannot communicate
Make decision / Unable to decide
When do you not gain consent
If it is to save life
If time is gonna kill them
Try to find out what they would have wanted
Explain why you didn’t get consent
Who can consent
Adult with capacity
Parent of child up to 16 (must have parental responsibility if not a parent)
Court for a child
Adults with incapacity act
What is guardianship
Fiancne and welfare when they lack capacity to grant POA
Requires two medical certificates from GP and psychiatrist
Detailed report from MHO
If child refuses treatment is this allowed
Competent children <16 in England and Wales cannot refuse if in best interest
In scotland a parent cannot override a competent child’s decision
