consent and confidentiality

Question 1

—- is a fundamental ethical and legal requirement in medical practice and is based on respect for the patients autonomy

Answer 1

consent

Question 2

true or false :
1-The success of informed consent depends on patients being able to understand and sufficiently retain the information they are given so as to enable them to analyse that information and use it to make a decision
2- its a process not once-off event

Answer 2

true , true

Question 3

the ethical principle of self-determination expressed in law through —-

Answer 3

concept of consent

Question 4

-the need to respect patients right to self-determination aka autonomy and their right to control their life , and refuse treatment
- healthcare worker need to max the health week being and minimise the harm as well as they have the obligation to use fair resources which means the patient cant just demand wtv they won’t unless its effective
- all of these fall under:

Answer 4

ethical rational

Question 5

informed consent and valid consent require 5 elements which are:

Answer 5

1-Disclosure of information – reasonable person standard, forced information, breach of autonomy?
2-Comprehension – two-way communication, info provided
3-Voluntariness/ choice– free of controlling influences e.g. social/financial
4-Competence/Capacity – sufficient rationality and intelligence – value-laden?
5-Agreement – documentary evidence

Question 6

when providing info you need to consider the patients —– , —-, —- and make sure to not withhold any info and they have support access . professional interpreter is needed once there’s a language barrier

Answer 6

• priorities and needs as: their beliefs/culture/occupation
• timing

Question 7

in assessing patient capacity you must consider:

Answer 7

• level of understand and their ability to retain info
• ability to apply the info to themselves and come to a decision
• ability to communicate their decisions w/ help or support needed

Question 8

best practice favours a — or —- approach to defining decision making capacity

Answer 8

• decision-specific or functional
  -aka it should be issue and time specific and depend upon the ability for someone to comprehend
• the functional approach recognises that there is a hierarchy of complexity in a decision and also that cognitive deficits are only relevant if they actually impact on decision making.

Question 9

best practice and international human rights standards favours —

Answer 9

supported decision making

Question 10

true or false: ( appointees )
One of the most important innovations in the 2015 Act is that it allows a relevant person to appoint someone to act as their supporter, either as: A Decision-Making Assistant or A Co-Decision-Maker.
The Circuit Court may appoint a Decision-Making Representative on behalf of the relevant person.
If authorised to do so by the Court, a Decision-Making Representative may consent to and refuse medical treatment on behalf of the relevant person. However, they cannot be authorised to refuse life-sustaining treatment.

Answer 10

trueee

Question 10

true or false:
decison-making assistant is the best and most formal tier

Answer 10

FALSE , its the least

Question 11

mid-tier and more formal support and can be a — or a —-

Answer 11

• co-decision making
• friend in a pre-trusted exisiting rs of trust or a family member

Question 12

decision making representation is when the court make a declaration that relevant person —- so basically the — makes the deciosns

Answer 12

lacks capacity , the court

Question 13

true or false :
in decision making representation order, may appoint one or more than one person for different decisions

Answer 13

true

Question 14

in decision making representative - scope of authority they cant —-

Answer 14

• cant prohibit contact w others
• authority confined to decisions in court order
• cant make decisions on life-sustaining treatment as consent or refusal
  -Shall not restrain relevant person unless exceptional emergency circumstances
• Shall not administer medication to control or modify behaviour of a relevant person

Question 15

——will be someone who helps with information and discussions, but will not actually make a decision for someone else;

Answer 15

decison making assistant

Question 16

—- will be a joint decision-maker

Answer 16

co-decision maker

Question 17

—–will be a substitute decision-maker.

Answer 17

decision making representative

Question 18

responsibility into seeking consent :
if its not possible for you to do so uni need to seek consent to another doctor who”:

Answer 18

-Is suitably trained and qualified.
-Has sufficient knowledge of the proposed intervention and of its benefits and risks.
-Is able to provide the information the patient requires.

Question 19

true or false:
You must delegate any part of the consent process to an intern unless the procedure is a minor one with which the intern is very familiar, and you have clearly explained the relevant information about the procedure to them

Answer 19

false , you must notttt

Question 20

true or false:
In such circumstances, as in emergency , you should provide such treatments as are immediately necessary to save the patient’s life or prevent serious harm to their health, unless you are aware of a valid and applicable advance refusal of such treatment.

Answer 20

true

Question 21

18.3 If you have doubts or concerns about the patient’s capacity to decline treatment, you must comply with the provisions of the —— or ——-

Answer 21

• assisted deciosn making ( capacity )
• mental health act 2001

Question 22

—– sets out clear guidelines to allow a person to make a legally binding refusal of treatment and to make treatment

Answer 22

advance healthcare directives AHDs

Question 23

——- may also appoint someone to act as their Designated Healthcare Representative, and give this person authority to consent to and refuse treatment, including life-sustaining treatment, always with reference to the AHD

Answer 23

directive-maker

Question 24

—- is an adult’s written statement setting out type & extent of treatment to which adult consents to or refuses if adult losses capacity to make treatment decisions

Answer 24

Forms of Advance Healthcare Decision-Making AHCD

Question 25

the 2 forms of AHCD are:

Answer 25

Instructional directive i.e. directions for treatment &
proxy directive i.e. designated person is allowed to communicate patient’s treatment choices

Question 26

A refusal of treatment set out in an advance healthcare directive shall be complied with if:

Answer 26

1-at the time in question the directive-maker( lacks capacity )to give consent to
the treatment;
2-the( treatment) to be refused is( clearly identified) in the directive;
3-the (circumstances) in which the refusal of treatment is intended to apply are (clearly identified) in the directive.’

Question 27

true or false:
A request for a specific treatment set out in an advance healthcare directive is not legally binding but shall be taken into consideration during any decision-making process which relates to treatment for the directive-maker if that specific treatment is relevant to the medical condition for which the directive-maker may require treatment.’

Answer 27

true

Question 28

when there’s more than one interpretation aka ambiguity you need to:

Answer 28

1- consult
2- preserve
3- benefit

Question 29

who can make an AHD —- unless —— , —– , and —–

Answer 29

• 18 yo who has the capacity to refuse including bc of religious beliefs
• nowithstanding that the refusal can be unwise, not based on medical principles , and can lead to their death

Question 30

—– is a process that enables a patient to consider and express their will and preferences in relation to medical treatment that may be proposed at a future time when the patient lacks decision-making capacity. Where you have an ongoing professional relationship with a patient, it is good practice to engage in discussions about planning for their future healthcare. Which helps assessing the medical professionals when the patient is unable to communicate their wishes at a certain time

Answer 30

advance healthcare planning

Question 31

—- Directive is a legally binding document which enables patients to —-

Answer 31

• advanced healthcare directive
  -Make an advance expression of their will and preferences concerning treatment decisions that may arise if they subsequently lack capacity and/ or
  Name a person or persons authorised to make those decisions for them should they be unable to do so themselves

Question 32

If a patient is assessed as lacking decision-making capacity, you should take all reasonable steps to find out whether they have made an —-

Answer 32

advanced healthcare directives

Question 32

true or false: A request for a specific treatment in an advance healthcare directive is not legally binding but must be considered

Answer 32

true

Question 33

true or false: No other person such as a family member, friend or carer and no organisation can give or refuse consent to healthcare on behalf of an adult (over the age of 18 years of age) who lacks capacity unless . However they should be consulted

Answer 33

trueeee

Question 34

—- is used where impossible to obtain consent immediately for a necessary procedure Applies ‘where there is a need to take action but it is not possible to communicate with the assisted person, and the action to be taken is such that a reasonable person would take in the best interests of the assisted person in all of the circumstances.’

-But hospital must ‘seek the assistance of the court within a reasonably short time’.

Answer 34

doctrine of necessity

Question 35

read this:

Answer 35

The consent of a minor who has attained the age of 16 years to any surgical, medical or dental treatment which, in the absence of consent, would constitute a trespass to his or her person, shall be as effective as it would be if he or she were of full age; and where a minor has by virtue of this section given an effective consent to any treatment it shall not be necessary to obtain any consent for it from his or her parent or guardian.

Question 36

consent and refusal over the age of 16

Answer 36

1- 22.3.1 In line with current practice, a young person aged 16 years and over can give consent to medical, surgical and dental treatment. This also applies to treatment of a young person for a mental illness except where the young person has been admitted under the Mental Health Acts.
2-, where the young person gives consent to treatment, it is not necessary to obtain consent from their parent(s). It is however good practice to involve parent(s) in healthcare decision-making for young people, if the young person consents to their involvement.
3-The law relating to refusal of treatment by young people aged 16 and 17, against medical advice and against parental wishes, is uncertain. If this situation arises, you should consider obtaining legal advice as to whether a court application is necessary.

Question 37

consent and refusal under the age of 16:
- in general it should be obtained by —-
if that wasn’t possible you need to encourage them , if not you need to act in their —–

Answer 37

• parents
• best interests depending on their maturity , ability to understand , physical and mental health , welfare,protection

Question 38

In emergency situations it may not be possible to obtain consent from the child, young person or their parent(s) and there may be insufficient time to make an application to court without exposing the child or young person to an immediate risk of death or serious injury. In such circumstances, you should provide —–

Answer 38

minimum treatment necessary to preserve life or prevent serious harm to the child or young person. You should record the basis for your evaluation that immediate intervention is required and the steps which you have taken on this basis. See also paragraph 8 ‘Providing care in emergencies’.

Question 39

true or false :Adults who lack decision- making capacity must not be unfairly excluded from the potential benefits of research participation, nor may their lack of capacity to consent be used to inappropriately include them in research. However, special measures will need to be taken to protect their rights and interests.

Answer 39

true

Question 40

a —can act as a safeguard for both the doctor and the patient during an intimate examination. You should ask the patient if they would like a chaperone to be present and record their wishes.

Answer 40

chaperone

Question 41

other important areas of consent include :

Answer 41

Blood Transfusions
Clinical Photography and other recordings
Patient’s who cannot understand English
Deaf patients
Blind patients
Retention of Tissue
Post-Mortems
Coroners and Non-Coroners

Question 42

—–is usually understood to be private information that a person shares with another on the understanding that it will not be disclosed to third parties.

Answer 42

confidential info

Question 43

The Hippocratic Oath allowed —- to the duty of confidentiality , confidentiality was an absolute duty

Answer 43

no exceptions

Question 44

read ( WMA )

Answer 44

• The WMA Declaration on the Rights of the Patient:
  “All identifiable information…and all other information of a personal kind must be kept confidential, even after death.”
  -WMA International Code of Medical Ethics:
  “It is ethical to disclose confidential information when the patient consents to it or when there is a real and imminent threat of harm to the patient or to others and this threat can only be removed by a breach of confidentiality.”

Question 45

the right of — is a fundemental right and medical — is a practical expression of that right

Answer 45

privacy , confidentiality as its the centre of doctor-patient rs

Question 46

true or false:
25.2 Doctors have a professional and ethical duty to maintain patient confidentiality. However, this duty of confidentiality is not absolute. There are situations where the disclosure of relevant information is appropriate in the interest of patient care and there are also situations where disclosure of information is required by law or in the public interest. Doctors also have a legal obligation towards the personal data of their patients.

Answer 46

true ( patient consent is required for disclosure of info ab them to outside or within healthcare team except where required by law or public interest )

Question 47

read:

Answer 47

26.3 If a child or young person does not want to share information with their parents, you should usually try to encourage them to involve a parent in such circumstances. If they refuse and you consider it is necessary and in the child’s best interests for the information to be shared, you may, depending on the circumstances, consider disclosing information to parents. You should record your discussions and reasons for sharing the information.
26.4 Parents may be entitled by law to access their child’s medical records. You should tell children and young people that you cannot give an absolute guarantee of confidentiality

Question 48

true or false:
1-most patient understand that their info needs to be shared within their healthcare however it should have a justifiable basis
2-If a patient objects to this sharing of information, you should explain the implications for their treatment of a decision not to consent to the provision of information. The explanation should include, where relevant, an explanation that referral may not be possible without disclosing necessary information.

Answer 48

true , true

Question 49

read:

Answer 49

28.1 Before disclosing any identifiable information about patients outside the healthcare team, you must be clear about the purpose of the disclosure and that you have the patient’s consent or other legal basis for the disclosure. You must also be satisfied that:
You comply with the applicable data protection legislation.
It is not possible to use anonymised information.
You are disclosing the minimum information to the minimum number of people necessary.
The person or people to whom you are disclosing the information knows that it is confidential and that they have their own duty of confidentiality.

Question 50

People close to a patient, whether family, friends or support persons may, out of concern, request information about the patient. While their concern is understandable, can you disclose info?

Answer 50

NO NO NO

Question 51

read : ( sorry ur almost there I promise :D)

Answer 51

. Disclosure of patient information outside the healthcare team without consent :
-There are limited circumstances where you can disclose information without consent, when by law or in the public interest. When you disclose information as required by law or in the public interest, you should inform patients of the disclosure, unless this would undermine the purpose of the disclosure.
-Disclosure required by law You must disclose information where this is required by law. For example:
* When ordered by a judge in a court of law.
* When required by a tribunal or body established by an Act of the Oireachtas.
* When required under legislation.
* Where required by infectious disease regulations.
Where you know or have reasonable grounds for believing that a crime involving sexual assault or other violence has been committed against a child or other vulnerable person.

Question 52

does your confidentiality ends of their death ?

Answer 52

NO NO NO

Question 53

read:

Answer 53

29.2 Disclosure to protect other individuals and in the public interest
There can be a public interest in disclosing information where the benefits to another individual or society outweigh the duty of confidentiality. This may occur in exceptional circumstances to protect individuals or society from risks of serious harm, such as from serious communicable diseases or serious crime. You must carry out a balancing exercise of individuals rights and the public interest. You may consider legal advice before making disclosure in such circumstances. You should disclose the information to an appropriate person or authority and include only the information needed to meet the purpose.

Question 54

is it fine to take vids , photos or record the patient if necessary
?

Answer 54

yes duh

Question 55

If your using these videos for education purposes you need to make sure that –

Answer 55

the patients identity is not shown unless they agreed to

Question 56

read:

Answer 56

Photographic, video or audio recording by a patient during a consultation
You should be aware that patients may wish to record all or part of a consultation. If they wish to do so you should facilitate their request. If you consider that recording could have a negative impact on your consultation you should explain this to your patient and, if possible, come to agreement.