Consent

Question 1

What is consent?

Answer 1

Consent to treatment is permission by a person before any treatment, test or examination. Must be done on basis of explanation and is needed regardless of procedure.

Consent should always be informed
>16yo can consent to treatment if have capacity, <16yo can consent if they fulfil Gillick Competence

Fraser Guidelines relate specifically to contraceptive advice

Question 2

Who requires consent and how is obtained?

Answer 2

All patients require consent.

Medical decisions should be discussed and made as a partners, without coercion

Decisions should be recorded and reviewed

Question 3

What are the different expressions of consent?

Answer 3

Implied or verbal agreement for non invasive procedures
Express consent for minor or routine investigations
Written consent for procedures with higher risk

Question 4

What is capacity?

Answer 4

Capacity is the ability to understand, believe, retain and weigh necessary information in order to make a decision

It may fluctuate, and assessment of capacity must be time and decision specific

Question 5

What are the obstacles to capacity?

Answer 5

Impaired intellectual/mental capacity
Intoxication
Unconsciousness
Communication difficulties

Question 6

What is the legal framework of consent?

Answer 6

Adults with incapacity (Scotland) act 2000

Principles include: must be of benefit to patient, least restrictive option, takes wishes of person into account, consult with relevant others, encourage the person to use existing skills and develop new skills