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Medical Ethics > Consent > Flashcards

Consent Flashcards

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USMLE® Step 1 flashcards
1
Q

What are the 4 principles of ethics

A

Autonomy (confidentiality, consent, capacity)
Non-malfeasance
Beneficence
Justice (non-discriminant)

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2
Q

What is a duty of candour

A

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

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3
Q

What should you always do as a doctor

A 
Non-judgemental 
Personal views not important - fair presentation of facts, refer
Confidentiality
Don't exceed competency
Fitness to practise - raise concerns 
Patient best interest
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4
Q

What are types of consent

A

Implied
Verbal
Written
Rational - give patient enough info to make decision

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5
Q

What is consent

A

An adult of sound mind has right to determine what is done with body
Must be capable of understanding info given

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6
Q

What is negligence

A

Requires a failure in duty and causation (foreseeable damage)

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7
Q

What is the consent law

A

Cannot perform operation for no good reason, even if there is consent

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8
Q

When can you not gain consent

A

Unconscious
No capacity
Expediency
Cannot communicate

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9
Q

What does consent process involve

A 
Competency test
Examination
Differential
Treatment plan / alternatives
Risks and benefits of Rx and no Rx
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10
Q

What law does Scotland have for no capacity

A

Adults with Incapacity Act

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11
Q

What is Gilick Competent

A

Children >12 <16 can consent if they understand options and risks + benefits
Cannot be overridden by parents but can be by court

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12
Q

What is an advance directive

A

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

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13
Q

In regards to adults with incapacity how do you determine whether intervention should be made

A

Present and past wishes acknowledge
Views of nearest relative
Views of guardian / POA

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14
Q

What is the court powers

A

Determine whether info is released to nearest relative

Appoint nearest relative

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15
Q

What is the public guardian

A

Sets up and manages power of attorney
Holds and maintain documents relating to cases
Consult mental welfare commission

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16
Q

What is the mental welfare commision

A

Protective functions on personal welfare of an adult

17
Q

What is a continuing POA

A

Finance and property

18
Q

What is a welfare POA

A

Personal welfare

19
Q

How is a POA established

A

Written when person has clear capacity
No unsure duress
Granter understands nature and power

20
Q

What role does a doctor have in treating someone who can’t consent

A

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

21
Q

Can you carry out research on someone unable to consent

A

No unless purpose is to obtain knowledge of causes / Rx

22
Q

When does a person lack capacity

A

Cannot understand info
Unable to retain info
Cannot communicate
Make decision / Unable to decide

23
Q

When do you not gain consent

A

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

24
Q

Who can consent

A

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

25
Q

What is guardianship

A

Fiancne and welfare when they lack capacity to grant POA
Requires two medical certificates from GP and psychiatrist
Detailed report from MHO

26
Q

If child refuses treatment is this allowed

A

Competent children <16 in England and Wales cannot refuse if in best interest
In scotland a parent cannot override a competent child’s decision

Medical Ethics (7 decks)

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