Consent and Capacity Flashcards
What are the 2 aspects of material risk?
- Where a reasonable person in the patient’s position would attach significance to the risk.
- If the healthcare professional would be reasonable aware that the patient would attach significance to the risk.
What process needs to be followed prior to obtaining consent from the patient?
- Ensure patient understands process and their role
- They have the opportunity to consider all relevant information
- Shared understanding of clinical expectations and limitations of treatment.
True or False: Explicit consent is where the patient in verbal or written form is willing to undergo investigation/treatment/procedure.
False. It is in both verbal and written form.
What is implied consent? Give an example.
When a patient is willing to go through with a procedure/treatment without directly giving consent.
Patient is giving permission by rolling up sleeve and holding out arm for a BP measurement.
What are the three legal requirements when gaining consent from a patient?
- Informed consent must be voluntarily
- Patient must be capable of giving consent
- Must be informed with necessary information to make decision (e.g. material risk)
When should explicit consent be acquired?
- Treatment/procedure is complex and involves significant risks.
- Significant personal implications
- Clinical care is not primary purpose of treatment/procedure
- Part of research programme or care plan for patient’s personal benefit.
When may you have to ask the patient AGAIN for consent? Give an example.
If a different clinical investigation/treatment/procedure is required.
When patient has a course of vaccinations and comes to get it done.
Give some reasons why consent may be required again.
- Significant time since first consent was obtained
- Material changes to condition/investigation/treatment
- New information available
What is advanced care planning?
Patients in advance can say how they want to be treated later (may lose mental capacity in future)
True or False: If the patient has an advanced refusal for treatment, they can override compulsory treatment under the mental health laws.
False. If the patient has an advanced refusal for treatment, they cannot override compulsory treatment under the mental health laws.
Can an advanced refusal be overridden?
Yes
When must a healthcare professional discuss advanced care planning with a patient?
- The clinical condition will impact on the length or quality of life
- It will impair mental capacity
- Where mental incompetency is likely in the future.
What must be covered during an advanced care planning consultation?
- Patient’s wishes/preferences/concerns
- Personal beliefs/values
- Family/close relatives/friends/personal representatives (Legal Power of Attorney)
- Clinical interventions in a clinical emergency (CPR)
What is capacity? What is the age of capacity?
Ability of someone to make a decision for themselves in a situation.
16 and over.
True or False: The patient had the capacity to make a decision or they don’t.
True
-> There is no in between
What does it mean for a patient who lacks capacity?
They cannot make a decision because of an impairment or disturbance in mind or brain. This could be temporary or permanent.
Patient must be able to do what to have capacity?
- Understand information
- Retain information
- Comprehend and make a decision from the information
- Communicate the decision
Can children under the age of 16 have capacity?
No unless they have sufficient understanding or intelligence. They may have the capacity to consent to some treatments.
What happens if a child refuses treatment but a parent wants it for the child?
The courts can override the refusal.
-> seek legal advice
Can a healthcare professional provide contraceptive treatment to a minor without a parent?
Yes
What should be taken into account when giving a minor a contraceptive?
- They understand the advice
- We cannot persuade them to involve parents
- Minor continues to engage in sex with/without treatment
- Their physical/mental health may suffer
- Their best interests require contraceptive treatment
When does the rights of a parent to consent to medical treatment on behalf of their children end?
It continues until the child is 18.
-> applies to both parents
Who should you consult with if there is a doubt on capacity of a patient?
- Members of the clinical team
- Members of the nursing staff
- Other healthcare professionals
- Other clinical specialists
-> May seek advice from legal teams to determine mental capacity
In an emergency, if a patient is unable to give consent, when may you provide treatment?
- If it is in the patient’s best interests
- Is needed to save their life
- Treatment will prevent deterioration of their condition
-> as long as they haven’t declined the treatment in advance
