Consent in Adults

Question 1

What are the 2 aspects of the moral significance of consent?

Answer 1

autonomy - self ruling

nonmaleficience - best person to do this is the patient, will the patient be harmed?

Question 2

What are the 3 rules that protect and govern consent?

Answer 2

bodily integrity
professional competence
Art 8, Human rights act 1998 (Right to family and private life)

Question 3

What is difference between battery and negligence?

Answer 3

Battery - if you touch (treat) someone without their consent.
Negligence - if you obtain consent only because the patient does not know all the information about the side-effects and risks of the treatment.

Question 4

What is the clear difference between negligence and battery in terms of harm?

Answer 4

In battery it does not matter if the patient has been harmed or has benefitted. To be negligence the patient must have been harmed

Question 5

What 4 things are required before you gain consent?

Answer 5

1. Information
2. Capacity
3. Voluntary
4. Decision

Question 6

Describe what is meant by information?

Answer 6

• sufficient, including side effects, alternatives, no treatment
• communicated effectively
• balance struck re- amount as if this is misjudged it impacts on voluntariness

Question 7

How has the law changed about how consent is obtained in terms of the information part?

Answer 7

In the past, not all risks need to be disclosed as courts judged based on standards of other doctors (reasonable practitioner)
Now, it would be negligence as doctors are required to communicate all risks, since Montgomery case

Question 8

What is the Bolam test?

Answer 8

Non disclosure of information was held to be negligent if not in accordance with accepted practice

Question 9

What is the difference between the GMC guideline, the law and ethics?

Answer 9

There is no difference in terms of information

Question 10

Capacity is related to ………
It is not related to … or ……..and must be assessed at an ……. level
The patient must be able to ……… and ……. the information
Related to ……. of decision making process

Answer 10

• autonomy
• age or status
• undestand and retain
• complexity

Question 11

What are the 4 areas that assess capacity? Where did these come from? What do they now form a part of?

Answer 11

1. Understand
2. Retain
3. Weigh up
4. Communicate decision
   - originate from schziophrenia case, judge used these to make a decision
   - now form part of the mental capacity act 2005

Question 12

What are the two ways someone can be coerced?

Answer 12

subtle - giving insufficient information about some options
unsubtle - linking in one form of treatment as conditional on receiving another (e.g. only performing an abortion if undergo sterilisation)

Question 13

What constitutes a decision when it comes to consent.

Answer 13

A yes or no answer

Or implied consent when a minor procedure

Question 14

If 3 previous elements are satisfied, the final decision must be ………, depsite any ……. outcome

Answer 14

respected

undesirable

Question 15

What are the exceptions to the consent law? x5

Is there are legal requirement for written consent?

Answer 15

Emergency treatment (doctrine of necessity)
Incompetent patients
Patient waiver
Therapeutic privilege (if giving the information will harm them)
Public Health Requirements
Implied consent

No but GMC says it should be down as it may protect the doctor