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Psychiatry Year 3 Dundee > Consent and Capacity > Flashcards

Consent and Capacity Flashcards

1
Q

What is valid consent

A

Given freely without distress or coercion and is legally capable of doing so

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2
Q

What is capacity ?

A

The ability to receive retain process and come to an informed decision on something.

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3
Q

What understanding is needed to consent to an intervention?

A

What is the intervention- nature and purpose
Main benefits and risks
Alternatives
Consequences

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4
Q

What is an Emergency Care Order?

A

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

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5
Q

Why in an emergency setting can you act without consent?

A

As consent should be assumed until proven otherwise

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6
Q

In order to enact the Adults With Incapacity Act 2000 what key criteria must be met?

A

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

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7
Q

What is section 47 of the Adults with Incapacity Act 2000

A

Certificate of incapacity

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8
Q

What does a section 47 Certificate of Incapacity allow?

A

Authorises practitioner to provide reasonable intervention related to treatment.

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9
Q

What does a section 47 Certificate of Incapacity not allow?

A

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.

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10
Q

Give an example of when a section 47 certificate of incapacity would allow the use of force.

A

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.

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11
Q

When is an attorney chosen?

A

Granted whilst patient has capacity

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12
Q

What is the power of the attorney ?

A

Power to act in place of the patient in terms of welfare and finance

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13
Q

How does someone apply to be a guardian?

A

One or more people or a local authority.

Scrutinised in court

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14
Q

What are the powers of a guardian?

A

Welfare and financial - long term decisions

Unable to place patient in a hospital against their will

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15
Q

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.

A

They can issue a compliance order.

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16
Q

What does the Mental Health Act 2003 allow for?

A

Treatment of mental disorder or physical consequence o disorder in someone without capacity to consent.

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17
Q

What is a section 36 in the Mental Health Act 2003?

A

Emergency Detention

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18
Q

What are the requirements for issuing as section 36?

A

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

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19
Q

What is a section 44 in the Mental Health Act 2003?

A

Short term detention

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20
Q

What are the requirements for issuing a section 44?

A

Significantly impaired decision making and metal disorder.
Detention to treat or prevent harm to self or others
Cant be treated voluntarily

21
Q

What does the age of legal capacity act 1991 determine?

A

At 16 years old you are presumed old enough to have capacity to consent.

22
Q

What is the general rule on consenting in children?

A

Ability to consent is done on competency not age.

23
Q

What did the Childrens Act 1995 determine?

A

If a child lacks capacity ask one parent, if parents disagree seek legal advice.

24
Q

What are the 10 Millan Principles used to ensure dignity of patient is maintained?

A 
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
25
Q

When someone says they present a risk to themselves what can the cover?

A

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.

26
Q

What is a Mental disorder?

A

Mental illness, disability or personality disorder

27
Q

What is not a mental disorder? So you can’t be defined for.

A

Sexual orientation or deviancy
Dependancy on drugs or alcohol
Acting as no other prudent person would ask

28
Q

Emergency detention order - Section 36

A

72 hour assessment
Not authorised to treat unless life saving
No right of appeal

29
Q

Who can authorise a Section 36 Emergency detention?

A

Fully registered Dr FY2 or above

A mental health officer should be present

30
Q

Short term detention order - Section 44

A

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.

31
Q

Who can authorise a Section 44?

A

Approved medical practitioner with a Mental Health Officer

32
Q

How long does a Compulsory Treatment order last ?

A

Initially up to 6 months, can be renewed

33
Q

What is needed in order to get a Compulsory Treatment Order?

A

ICD10 medical disorder diagnosed
Approved medical practitioner and MHO decide.
MHO makes application to tribunal service.
Tribunal service authorises treatment.

34
Q

What is needed by the MHO to send to the Tribunal service to get a CTO?

A

Reports from two independent Drs
Care plan
MHO report

35
Q

When could emergency treatment be administered without consent?

A

Save life
Prevent serious deterioration in condition
Alleveiate serious suffering e.g. physical or mental
Prevent a danger to others

36
Q

What must be completed after administering emergency treatment to a non consenting patient?

A

T4 certificate up to 2 days post

37
Q

What treatments are not authorised under a general CTO or short term detention?

A 
ECT 
Nutrition
Vagus nerve stimulation
Neurosurgery
Medication to reduce sex drive
38
Q

Patients advanced statement in CTO.

A

Can be overuled

Must be taken into account by the tribunal

39
Q

Named person

A

Patient chooses someone to support, represent ad protect their interest.
Cant be a medical professional working on or near them.

40
Q

What are a named persons rights?

A

Same rights as the patient

Must be notified to attend and represent the patient at the tribunal should they so wish.

41
Q

In a patient under the age of ten what happens in regards to a named person?

A

They are automatically appointed.

Anyone who has parental responsibilities for the child.

42
Q

Advocacy in mental health patients.

A

Every person regardless of mental disorder or illness has the right to access independent advocacy or legal advice.

43
Q

Generally who makes up a mental health tribunal?

A

Psychiatrist
Solicitor
3rd person with experience in the field

44
Q

Which nurses have the power to hold a patient within the care setting?

A

Mental Health Nurse

Intellectual Disability Nurse

45
Q

When could a nurse hold a patient?

A

Patient within a hospital setting and receiving treatment but nurse has a fear they may abscond.

46
Q

How long can a Nurse hold a patient against their will?

A

Up to 3 hours

Allowing the Dr to attend and detain

47
Q

What powers do the Police have to detain someone with a mental disorder?

A

Removal of patient from public setting to a place of safety if suspicion of metal illness.

48
Q

What is the job of the Mental Welfare Commission ?

A

Encourage best practise
Publish information and Guidance
Carry out visits investigations and interviews

Psychiatry Year 3 Dundee (21 decks)

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