Consent in Adults with Capacity Flashcards
When can a patient give consent
When they have capacity, are adequately informed and voluntarily agrees to treatment, examination or another aspect of healthcare
For consent to be valid the patient must
Have capacity
Be offered sufficient information to make an informed decision
Be acting voluntarily and free from undue pressure
Be aware that he or she can refuse
Implied consent
Indicated through actions such as opening mouth or offering arm for blood pressure
Expressed consent
Consent given orally or written down
To have capacity to make medical decisions the patient should be able to
Understand in simple language what the proposed treatment it
Understand the benefits, risks and alternatives
Understand in broad terms what the consequences will be if they do not undertake the proposed treatment
Retain the information for long enough to make a decisions
Weigh the information, balancing the risks and benefits, to arrive at a choice
Communicate decision
State the GMC guidelines on explaining and obtaining consent and the delegation of the task
If you are the doctor undertaking an investigation or providing treatment, it is your responsibility to discuss it with the patient.
This can be delegated to another but they must be
suitably trained and qualified, have sufficient knowledge of the proposed examination. However, you are still responsible for ensuring valid consent is obtained
Information given to the patient is only valid if
It is provided in a manner that is accessible and intelligible to the patient, and is given at a pace in which the recipient can understand,
What information does the GMC state must be given to the patient when obtaining consent
The diagnosis and prognosis
Any uncertainties about either
Options for treating or managing
The purpose of whats being proposed and what it will involve
The potential risks, benefits and burdens and the liklihood of success of each of the options
The people who will be involved in their care and what their roles are
Their right to refuse to take part in teaching or research
Their right to seek a second opinion
Any bills they will have to pay
Any conflicts of interest that the doctor, or healthcare organisation, may have
Witholding information from a patient
Information can only be witheld from patient if it is deemed to have deletrious effect on their health. The reasons for this must be documented
Written consent should be obtained in cases where
The procedure is complex or involves significant risks
Consequences on the patients employment, or social or personal life
Providing clinical care is not the primary purpose of the procedure
The procedure is part of a research programme or is designed specifically for the patients benefit
If treatment involves a number of invasive or complex procedures over time, what must be done
consent obtained for each intervention
What else should be discussed as part of the consent process
Forseeable complications and what the patients wishes are if they are to arise
What should always be ensured to prevent patients consenting under undue pressure
That the patient has the opportunity to make the desicion away from family and friends
Are adult patients with capacity have the right to refuse treatment
Yes. They have the right to refuse any medical treatment, with the exception of compulsory treatment authorised under mental health legislation, even if that refusal results in permanent physical injury or death to them or a viable fetus.
What information should patients be offered to allow them to refuse treatment
The nature of their condition The proposed treatment Significant risks or side effects Probability of a successful recovery Consequences of not having the treatment Alternative forms of treatment
