consent, capacity and the law

Question 1

what are the 9 standards?

Answer 1

put px interests 1st
communicate effectively with px
obtain valid consent
maintain aand protect px info
have a clear and effective complaints procedure
work w/ colleagues in a way that puts px interests 1st
maintain, develop and work w/i your professional knowledge and skills
raise concerns if px are at risk
make sure personal behaviour maintains px confidence in you and the dental profession

Question 2

what are the conditions for consent?

Answer 2

valid and legal

Question 3

what makes consent valid?

Answer 3

remains current
specific to proposed dental tx only
was obtained recently enough

Question 4

how long does consent remain valid?

Answer 4

continuing process- not one-off
when there has been a significant interval between the px agreeing and the tx start consent should be renewed
give px continuing opportunities to ask and review decision

Question 5

what are the principles of legal consent?

Answer 5

ability
-ability to make informed decision
informed
-enough info given
voluntary
-px made decision

Question 6

what is capacity?

Answer 6

to act
to make a reasoned decision
to communicate a decision
to understand a decision
to retain the memory of a decision

Question 7

who has ability to consent?

Answer 7

any px to give/withhold consent
from age 16 unless assessed otherwise
no other person may give consent on behalf

Question 8

when do children have ability?

Answer 8

with sufficient maturity and intelligence to understand nature & implications of proposed tx
when adult giving consent=must have parental reponsibility
mum automatic
dad must be married to mum/name on birth certificate
parental responsibility kept after divorce but lost when giving up for adoption

Question 9

what is informed conent?

Answer 9

sufficient info must be communicated so px can make a decision based on appropriate knowledge and understanding

Question 10

what is needed for informed consent?

Answer 10

specific q’s answered fully and honestly
info given should be documented
tx not exceed consent given
px individual needs/wishes checked

Question 11

what might a px want to know about a tx?

Answer 11

options- risks & benefits
why you think it is necessary/appropriate
consequences
likely prognosis
recommended option
what would happen if not carried out

Question 12

what are material risks?

Answer 12

where a reasonable person, if warned of the risks would be likely to attach significance to them
the dentist is aware that this particular px if warned would be likely to attach significance to them

Question 13

what are the 6 things needed for consent?

Answer 13

valid
with capacity
informed
voluntary
not coerced
not manipulated

Question 14

what are the modes of obtaining consent?

Answer 14

implied/explicit
implied for minor procedures
implied consent for minor procedures
explicit for major/invasive 
procedures
oral/written equally lawful
-properly documented
written required for general anaesthetic/conscious sedation
written filed safely

Question 15

when is consent not required?

Answer 15

emergency and not possible to find out px wishes
provided tx immediately necessary
must be least restrictive of px future choices
if regains capacity should explain whats done and why

Question 16

what does the adults with incapacity act do?

Answer 16

allows people to make their own choices about who will handle their affairs if they cannot do it themselves eg power of attorney

Question 17

what is an intervention order?

Answer 17

for a situation where there is no PoA and a one-off decision needs to be made on behalf of adult with incapacity

Question 18

what are the 5 principles of the adults with incapacity act?

Answer 18

• benefit of adult
• minimum intervention
• present and past wishes of adult
• consultation with the adult and others
• adults exercising of their skills and further development of these

Question 19

what are the conditions in using the act?

Answer 19

benefit to adult cannot be achieved any other way
no way that would take less responsibility from adult
adult asked about present wishes and others asked for past known wishes
person should be consulted about any action
adult must be encouraged to do as much as possible

Question 20

what links capacity and consent?

Answer 20

autonomy