Consent, Capacity and Refusal in Adults

Question 1

Acting without consent can lead to- what?

Answer 1

criminal offence (assault and battery) or civil action from patient (claim for damages)

Question 2

Exceptions to Consent? (4)

Answer 2

• emergency (no time, hence act in patients best interests)
• implied (through patient’s actions)
• waiver (patient doesn’t want to hear details, just start treatment)
• best interests (if not possible to gain consent or patient lacks capacity, doctor acts in best interests of patient)

Question 3

Who can’t waiver to exempt a patient from consent?

Answer 3

Patient’s relatives on behalf of the patient (they don’t want patient to know details of their diagnosis/treatment) but you shouldn’t agree to this unless there’s a REALLY good reason for doing so that won’t affect patient outcomes

Question 4

Need to be competent to give valid consent- what does this include? (4)

Answer 4

No one can consent on behalf of a competent adult, who can:
- understand information
- retain information
- use information
- communicate decision

Question 5

What balance needs to be made when giving patients info about a treatment?

Answer 5

Doctors should provide the info in ‘broad terms’ - such that their specific patient would reasonably want to know (and not so much as to overburden the patient and not so little that they don’t mention any common or serious risks of the procedure)
If a patient asks a specific q, the doctor must answer it

Question 6

What are the rules with assuming competence in adults vs children under 16?

Answer 6

Competence is decision-specific. Consent must be given without coercion.
- Adults (16+) assumed to be competent unless evidence suggests otherwise
- Children (<16) assumed to lack competence unless evidence suggests otherwise.