Consent and Capacity Flashcards
What is valid consent
Given freely without distress or coercion and is legally capable of doing so
What is capacity ?
The ability to receive retain process and come to an informed decision on something.
What understanding is needed to consent to an intervention?
What is the intervention- nature and purpose
Main benefits and risks
Alternatives
Consequences
What is an Emergency Care Order?
Legislation allowing a patient to be detained in hospital where they
A) have a mental disorder and
B) are deemed a risk to themselves or others if they are not treated in hospital
Why in an emergency setting can you act without consent?
As consent should be assumed until proven otherwise
In order to enact the Adults With Incapacity Act 2000 what key criteria must be met?
Intervention must benefit
Such benefit can not be achieved without intervention
Past and Present wishes taken into account
Consult with other relevant people
Encourage adult to use their residual capacity
What is section 47 of the Adults with Incapacity Act 2000
Certificate of incapacity
What does a section 47 Certificate of Incapacity allow?
Authorises practitioner to provide reasonable intervention related to treatment.
What does a section 47 Certificate of Incapacity not allow?
Not allowed too use force unless immediately necessary and only for as long as necessary.
Not specifically allowed to transport patient to place of treatment.
Give an example of when a section 47 certificate of incapacity would allow the use of force.
In an elderly patient with dementia falls and breaks her hip is actively resisting aid. You’d be able to restrain her whilst a sedative is administered.
When is an attorney chosen?
Granted whilst patient has capacity
What is the power of the attorney ?
Power to act in place of the patient in terms of welfare and finance
How does someone apply to be a guardian?
One or more people or a local authority.
Scrutinised in court
What are the powers of a guardian?
Welfare and financial - long term decisions
Unable to place patient in a hospital against their will
If a patient doesn’t comply with the will of the guardian what can the court do, if they decide it is the best thing for the patient.
They can issue a compliance order.
What does the Mental Health Act 2003 allow for?
Treatment of mental disorder or physical consequence o disorder in someone without capacity to consent.
What is a section 36 in the Mental Health Act 2003?
Emergency Detention
What are the requirements for issuing as section 36?
Likely to have a mental disorder
Significantly impaired decision making ability
Detention is necessary to determine treatment
Present a risk to themselves or others
A section 44 would provide undesirable delay
What is a section 44 in the Mental Health Act 2003?
Short term detention
What are the requirements for issuing a section 44?
Significantly impaired decision making and metal disorder.
Detention to treat or prevent harm to self or others
Cant be treated voluntarily
What does the age of legal capacity act 1991 determine?
At 16 years old you are presumed old enough to have capacity to consent.
What is the general rule on consenting in children?
Ability to consent is done on competency not age.
What did the Childrens Act 1995 determine?
If a child lacks capacity ask one parent, if parents disagree seek legal advice.
What are the 10 Millan Principles used to ensure dignity of patient is maintained?
Non discrimination Equality Respect for diversity Reciprocity - treatment is beneficial Informal care Participation - patient helps their own care in own way Respect for carers view Least restrictive - in terms of treatment Benefit Child welfare
When someone says they present a risk to themselves what can the cover?
A risk to their health welfare or reputation
e.g. running through the streets naked is detrimental to their reputation more so than their health.
What is a Mental disorder?
Mental illness, disability or personality disorder
What is not a mental disorder? So you can’t be defined for.
Sexual orientation or deviancy
Dependancy on drugs or alcohol
Acting as no other prudent person would ask
Emergency detention order - Section 36
72 hour assessment
Not authorised to treat unless life saving
No right of appeal
Who can authorise a Section 36 Emergency detention?
Fully registered Dr FY2 or above
A mental health officer should be present
Short term detention order - Section 44
Treatment is autherised
Up to 28 days for assessment and treatment
Right of appeal from patient and named person
Can be extended by three days to produced form for a CTO.
Who can authorise a Section 44?
Approved medical practitioner with a Mental Health Officer
How long does a Compulsory Treatment order last ?
Initially up to 6 months, can be renewed
What is needed in order to get a Compulsory Treatment Order?
ICD10 medical disorder diagnosed
Approved medical practitioner and MHO decide.
MHO makes application to tribunal service.
Tribunal service authorises treatment.
What is needed by the MHO to send to the Tribunal service to get a CTO?
Reports from two independent Drs
Care plan
MHO report
When could emergency treatment be administered without consent?
Save life
Prevent serious deterioration in condition
Alleveiate serious suffering e.g. physical or mental
Prevent a danger to others
What must be completed after administering emergency treatment to a non consenting patient?
T4 certificate up to 2 days post
What treatments are not authorised under a general CTO or short term detention?
ECT Nutrition Vagus nerve stimulation Neurosurgery Medication to reduce sex drive
Patients advanced statement in CTO.
Can be overuled
Must be taken into account by the tribunal
Named person
Patient chooses someone to support, represent ad protect their interest.
Cant be a medical professional working on or near them.
What are a named persons rights?
Same rights as the patient
Must be notified to attend and represent the patient at the tribunal should they so wish.
In a patient under the age of ten what happens in regards to a named person?
They are automatically appointed.
Anyone who has parental responsibilities for the child.
Advocacy in mental health patients.
Every person regardless of mental disorder or illness has the right to access independent advocacy or legal advice.
Generally who makes up a mental health tribunal?
Psychiatrist
Solicitor
3rd person with experience in the field
Which nurses have the power to hold a patient within the care setting?
Mental Health Nurse
Intellectual Disability Nurse
When could a nurse hold a patient?
Patient within a hospital setting and receiving treatment but nurse has a fear they may abscond.
How long can a Nurse hold a patient against their will?
Up to 3 hours
Allowing the Dr to attend and detain
What powers do the Police have to detain someone with a mental disorder?
Removal of patient from public setting to a place of safety if suspicion of metal illness.
What is the job of the Mental Welfare Commission ?
Encourage best practise
Publish information and Guidance
Carry out visits investigations and interviews
