Consent Flashcards
What is consent?
- Process (not single event)
- Should be informed
- Should involve voluntary decision making
- Individual should be able to make an informed decision
GDC Standards Guide: What are the principles of patient concent (2005)?
- Non-verbal = Routine examination
- Verbal = single treatment
- Written = Extensive Treatment (GA, Sedation sometimes extractions)
How do you test for capacity?
Individual must be able to:
- Understand information
- Retain information
- Weigh out the pros and cons in order to make an informed decision
- Communicate their decision by any means
Can 16-17 year old who has capacity give consent
Yes although if there is evidence of significant harm, involve the family. However, entitled to make an unwise decision. But consent may be overriden by parent s or a court ‘in their best interest’.
What must you consider if someone is 16+ and does not have capacity?
- Will they regain capacity
- Views and opinions of other relevant individuals (e.g. Local Authority, parents, health professionals)
- Persons past decisions or patterns of behaviour
N.b. if they do not have capacity then reasonable and proportionate force can be used to carry out treatment.
Conflict: final decision lies with clinician!
Can a child aged under 16 give consent?
Depends on child’s ability to understand the nature and implications of the treatment.
There is no fixed age at which a child has capacity to consent.
What factors would you need to consider in order to deem a child Gillick Competent?
- Able to understand that there is a choice
- Willing and able to make a choice
- Able to understand the nature and purpose of the proposed treatment
- Able to understand associated risks and side effect
- Able to understand the alternatives to the procedure, the risks attached to them and consequence of no treatment
- Free from pressure
If the child is able to understand and make an informed decision they are deemed Gillick Competent. Although it is good practice to involve the parent.
Do adoptive parents have parental responsibility?
If they were married when they jointly adopt = both have parental responsibility.
- Both keep parental responsibility if they divorce.
- Child loses all legal ties to biological parents.
Do married fathers have parental responsibility?
If married at time of birth or mother marries the child’s biological father = Yes
And keep parental responsibility if they later divorce.
Do unmarried fathers have parental responsibility?
- If child was born before 1st Dec 2003 = no
- If child is born after 1st Dec 2003 and named on birth certificate = Yes
How can fathers gain parental responsibility?
- Agreement with mother
- Court order
- If the biological father marries the biological mother of his child after the birth, they will automatically gain parental responsibility.
Do same sex parent have parental responsibility?
If they were civil partners at the time of treatment (Donor insemination or fertility treatment)= Yes
For same sex-partners who aren’t civil partners then 2nd parent can acquire parental responsibility by
- Parental responsibility agreement
- Jointly registering the birth
Under what circumstances does the local authority have parental responsibility?
- If child is in foster care
- If there is a care order
- If under emergency protection
When does the court have parental responsibility?
If child is a Ward of Court
When does the legal guardian have parental responsibility?
If parents die
