Consent - Mental Capacity Act 2005

Question 1

What are the 4 types of consent?

Answer 1

Informed consent
Valid consent
Explicit consent
Implied consent

Question 2

What 3 things need to have happened to have gained valid informed consent?

Answer 2

Be competent to take a particular decision
Have received sufficient information to make the decision
Not be acting under duress

Question 3

What is explicit consent?

Answer 3

articulated agreement
relates to a clear and voluntary indication of preference of choice
usually given orally or in writing
freely given in circumstances where the available options and the consequences have been made clear

Question 4

What is implied consent?

Answer 4

agreement that has been signalled by the behaviour of an individual with whom a discussion has been held about the issues and therefore understands the implications of the disclosure of information

Question 5

What is delegated consent?

Answer 5

Consent taken for a procedure by someone not competent to carry out the procedure
Should not happen within healthcare

Question 6

What is Independent Mental Capacity Advocacy (IMCA)?

Answer 6

Assist decision making for vulnerable and unsupported adults in relation to serious medical treatment or placement in long-term care
Used when no close relatives/friends or LPA

Question 7

What patients come under the mental capacity act?

Answer 7

Patients with:
dementia
with learning disabilities
with brain injury
with severe mental health problems
Anyone planning for the future
with temporary loss of capacity e.g. unconscious, delirium

Question 8

What is a lasting power of attorney?

Answer 8

Allows patient to state who you would like to make decisions on your behalf when having capacity should you become unable to do so in the future
Must register with the new Public Guardian
Does not include decisions about withholding life-saving treatments unless specifically stated

Question 9

What are the 5 principles of the mental capacity act?

Answer 9

Presumption of capacity
Supported participation in decision-making
A right to make unwise or eccentric decisions
Best Interest
Least restrictive alternative

Question 10

What is meant by the first principle - presumption of capacity?

Answer 10

Right of every adult to make his or her own decisions
Always start with the assumption of capacity
Must prove that capacity does not exist (on the balance of probability)
Capacity relates to the particular decision to be made at that particular time i.e. it is decision and time specific

Question 11

When is a person presumed to not have capacity?

Answer 11

The person fails to:
Absorb basic information about the pros and cons of an issue or decision
Retain the information for long enough to process it
Use or weigh up the information
Communicate the decision by any means

Question 12

What are the 2 stages of assessing capacity?

Answer 12

1) is there an impairment/disturbance in the functioning of the persons brain
2) After being given all the appropriate help, the person cannot understand the information given, retain it long enough, weigh the information in balance or communicate their descion

Question 13

What is meant by the second principle - supported participation in decision making?

Answer 13

Everybody should be encouraged and enabled to participate as fully as possible in decision-making
Appropriate help and support should be available

Question 14

What are the 2 public bodies supporting the statutory framework?

Answer 14

New Court of Protection

New Public Guardian

Question 15

What are the jobs of court appointed deputies?

Answer 15

The Court of Protection can appoint deputies to make decisions on welfare, health and finance
A deputy may not:
Override an LPA
Refuse life-sustaining treatments

Question 16

What is meant by the third principle - The right to make unwise or eccentric decisions?

Answer 16

Can not assume incapacity just because decisions are not those that we would consider a rational person should make
Must respect the decisions made if the tests of capacity hold

Question 17

What is meant by the forth principle - best interest?

Answer 17

Best interest is wider than medical best interest and must look at the person as a whole
Previous preference must be taken into account
It is an attempt to do what the person would have wanted (provided it is legal)
Best interest decisions can not override a valid advanced directive

Question 18

What is a advanced directive?

Answer 18

A decision made by an adult, who at the time has competence, to apply to circumstances where competence is lost in the future
Can only relate to refusal of treatment

Question 19

What is the criteria to have a valid ‘refusal of life saving treatment’?

Answer 19

Be in writing
Be signed and witnessed
The treatment refused must be specific
It must be clear that the decision stands even if life is at risk
The AD must be valid at the time and applicable to the circumstances

Question 20

What is meant by the fifth principle - least restrictive alternatives?

Answer 20

When a decision is made on behalf of a person it should be the least restrictive of their basic rights and freedoms