Elderly Care - capacity and consent (Law and Ethics) Flashcards
Considerations when caring for the elderly
Complex health and social needs
Additional communication support required
Deferential towards doctor (reduced autonomy?) “Doctor knows best”
Impaired/fluctuating capacity
More dependent on social/family support
Ethical considerations when dealing with an individual with dementia?
Autonomy and right to self determination - autonomy only valid if informed
- Autonomy might not be as highly valued as by the doctor/ethicist
-What are the consequences of treatment - QOL?
- How to assess QOL in a patient with cognitive impairment?
- How to reconcile pre/post dementia values?
- Right to life persists even when the person does not have capacity
Criteria for assessing capacity?
Do they understand the relevant info?
Can they retain the relevant info?
Can they weigh up the information and form a decision?
Can they communicate a decision?
DOCUMENT
Important points re. capacity
Dynamic and decision specific
Fluctuating (confusion/pain/shock)
Presumed until proven otherwise
No capacity= Valid LPA/Valid AD/patient advocate
Decisions on behalf must be made in their best interests, with least possible restriction of basic rights and freedoms
Unwise does not mean they do not have capacity
Consent must be…
Informed - Procedure, Alternatives, Risks, Questions
Voluntary - Free from undue influence, must be able to refuse and know that can refuse
Competent
Consent must be…
Informed - Procedure, Alternatives, Risks, Questions
Voluntary - Free from undue influence, must be able to refuse and know that can refuse
Competent
