Consent and capacity Flashcards
What is consent (don’t learn off by heart)
The voluntary and continuing permission of an appropriately informed person who has the capacity to consent to the intervention in question, based on a sufficient knowledge of the purpose, nature, likely effects and risks of that treatment, including the likelihood of its success and any alternatives to it. Acquiescence under any unfair or undue pressure, or where the person does not know what the intervention entails, is not ‘consent’.
What are the 9 key principles of the GDC
- Put patients’ interests first
- Communicate effectively with patients
- Obtain valid consent
- Maintain and protect patient’s information
- Have a clear and effective complaints procedure
- Work with colleagues in a way that is in the patients best interests
- Maintain, develop and work within your professional knowledge and skills
- Raise concerns if patients are at risk
- Make sure your personal behaviour maintains patient’s confidence in you and the dental profession
Regarding consent, what does the GDC state in the standards that you must do
- 1 Obtain valid consent before starting treatment, explaining all the relevant options and the possible costs
- 2 Make sure that patients (or their representatives) understand the decisions they are being asked to make
- 3 Make sure that the patient’s consent remains valid at each stage of investigation or treatment
what are the conditions for consent
Consent must be both valid and legal
What does ‘valid consent’ mean
- remains current (patient still agrees)
- specific to the proposed dental treatment only
- was obtained recently enough
How long does consent remain valid
- consent should be perceived as a continuing process rather than an irrevocable, one-off decision
- where there has be a significant interval between the patient agreeing to a treatment option and its start, consent should be renewed
- give continuing opportunities to review the decision as they may have changed their mind/ may have been clinical developments
What are the principles of legal consent
- Ability (the patient has the ability to make an informed decision)
- Informed (the patient has enough information to make a decision)
- Voluntary (the patient has made the decision)
What are the 6 aspects of consent
- valid
- with capacity
- informed
- voluntary
- not coerced
- not manipulated
What are the 5 aspects of capacity
- To act (i.e. to decide)
- To make a reasoned decision
- To communicate a decision
- To understand a decision
- To retain the memory of a decision
Who has ability to consent
- any patient with capacity
- anyone over 16 is presumed to have capacity
- no other person may lawfully give consent on behalf of a patient who has capacity
do patients under 16 have the ability to consent
- yes, with sufficient maturity and intelligence to understand the nature and implications of the proposed treatment
what do you have to make sure when an adult is giving consent for a child’s treatment
that the person has parental responsibility
is parental responsiblity kept after divorse
yes
What things might your patients want/ need to know
- options for treatment, the 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 the proposed treatment
- what might happen if the proposed treatment is not carried out
- whether treatment is guaranteed, how long it is guaranteed for and any exclusions that apply
- a reminder that the patient can change their mind at any time
Material risks must be discussed, what are these
- a reasonable person, if warned of the risks, would be likely to attach significance to these
- the dentist is aware, or should reasonably be aware that the particular patient, if warned of the risks, would be likely to attach significance to these
- risk communication should reflect likelihood, severity and significance to the patient
