Consent Flashcards
What is Consent in Healthcare?
Legal and ethical principle that valid consent must be obtained before starting treatment or physical investigation, or providing personal care, for a person.
What do the GDC ensure you do with regards to consent?
- Explain the principles of obtaining valid patient consent
- Obtain valid consent from the patient before starting treatment, explaining all the relevant options and possible costs
- Explain and check patients’ understanding of treatments, options and costs to enable patients to make their choice and give valid consent
- Obtain valid consent
What is the Montgomery v Lanarkshire Health Board [2015] UKSC 11 case outcome?
The practitioner must take reasonable care to ensure that a patient is aware of any material risks involved in a proposed treatment, and of reasonable alternatives.
When is a risk material?
If a reasonable person in the patient’s position would be likely to attach significance to it, or if the practitioner is, or should reasonably be aware, that the patient would be likely to attach significance to it.
What does Montgomery mean in practice?
“You should do your best to understand the patients’ views and preferences about any proposed investigation or treatment, and adverse outcomes they are most concerned about. You must not make assumptions about a patient’s understanding of risk or the importance they attach to different outcomes”
What is the ‘Prudent Patient Test” for consent?
A test for assessing whether informed consent was given prior to a procedure, based upon whether the patient received information about risks that a reasonably prudent patient would need to consider in making a treatment decision
So you must focus on what the patient would want to know. You are expected to spend more time in tailoring your disclosures according to individual patient’s priorities, circumstances and concerns, as different individuals have different needs for information.
What is the GDC Standards (2013) incorporate Montgomery (2015)?
GDC Standard 3.1.3
You should find out what your patients want to know as well as what you think they need to know. Things that patients might want to know include: options for treatment, their risks and potential benefits;
why you think a particular treatment is necessary and appropriate for them;
the consequences, risks and benefits of the treatment you propose;
the likely prognosis;
your recommended option;
the cost of proposed treatment;
what might happen if the proposed treatment is not carried out;
and whether the treatment is guaranteed, how long it is guaranteed for and any exclusions that apply.
What is valid consent in dentistry?
For consent to be valid it must be informed consent. For this to be the case it must be:
- Given voluntarily (no coercion or deceit)
- Given by an individual who has capacity
- Given by an individual who has been fully informed about the issues bearing in mind the obligations of Montgomery and GDC Standards
- Given anew when material risks change or when treatment options or treatment changes
- Given with the patient’s knowledge that they can withdraw consent at any time
What types of consent are valid in dentistry?
Consent can be written, verbal or non-verbal/implied.
A written consent form is not the actual valid consent itself. It is simply evidence that an attempt at consent has been undertaken
There is a statutory requirement for written consent for sedation and general anaesthesia
Implied consent is an action such as offering your arm for a blood samples. It can be unreliable as a patient can argue that their actions were misunderstood and they did not actually wish to consent.
What do you record with consent?
Record what you talk about, record what you advise and advice given to you, record what the patient says and decides, record the options given and the material risks and benefits in the individual circumstances of the case – and do this for every course of treatment.
Consent is a process not just a signature on a page
Who knows best when the Bolam test for consent is applied?
A reasonable body of doctors.
You decide you need to perform an ultrasonic scale on a patient with asthma during the Covid pandemic. What material risks you should discuss to obtain valid consent?
Higher risk of a poorer outcome if contracts COVID. and seensitivity after scalling.
What is a “material risk” in modern UK Consent Law?
a risk that a reasonable person in the patients position would be likely to attatch significance to.
The Age of Legal Capacity in Scotland is 16? true/false
true
