Ethical considerations Flashcards
What is the 2 part test for judging capacity
Mental Capacity Act 2005 (FOR ADULTS)
1. Does they have an impairment of the mind/brain whether as a result of illness, ext factors
- Does this impairment mean that the person that they are unable to make a specific decision when needed
- can they understand, retain, weigh up and communicate their decision?
What does the MCA 2005 say
-how can you support this
Assume capacity unless proven otherwise
Help people make their own decision but must respect unwise decisions
-provide info in a form that is easier for them to understand
-could another person help with communication
-are there times in the day or places when a person’s understanding is better?
-can the decision be delayed until they are more likely to have capacity?
What should you do if someone is deemed to not have capacity
Must be in their best interests
Treatment and care must be the least restrictive of their basic rights and freedoms
-encourage patient participation
-gather info on the patient’s views and beliefs
Consult
- NOK, close relatives and friends
- LPAs, deputies appointed by Court of Protection
Try to find the least restrictive option that’s in their best interests
-whether we need to act at all?
What is a Deprivation of Liberty Safeguard
Must be done under the Mental Capacity but different to being detained under the Mental Health Act
To be used if it is the least restrictive way of keeping you and others safe when you lack capacity in a care home or hospital
Under continuous supervision and control
Must apply for authorisation beforehand to protect individual
- patient given representative to monitor them
- either can challenge the order via the Court of Protection
- DOL reviewed and monitored regularly
If needed urgently, can request it from a managing authority along with standard authorisation
What is an advance statement and decision
How does this differ from an advance decision to refuse treatment/living will?
Not legally binding written statement that sets down preferences regarding future care if they lose capacity
- religious, spiritual beliefs to be reflected in care
- where they would like to be cared
- how they like to do things
- concerns about practical issues
Legally binding decision that can be made when 18+ with capacity to refuse treatment in the future should they lose capacity to consent. Not easily found in medical records
YOU CANNOT ASK FOR TREATMENT
Must be
- applicable to the current circumstance
- in writing, signed and witnessed
- state clearly that the decision applies even if life is at risk
What is an LPA
Can grant LPA by registering other people to enable them to make decisions about
- health and welfare
- property and finances
Only to act when the patient lacks capacity
What is the Court of Protection
Oversees operation of the MCA
Deals with issues relating to people who lack capacity to make their own decisions
Cases can be brought to the court by family members, advocates, professionals
What is a DNACPR order
Who makes the decision
Decision is made with you and/or medical team
-does not need your consent but you will be informed that it has been completed but you can ask for a review
Discussed with you, form completed by doctors and put in medical records
Can last for a short period or with no end date and reviewed if situation changes
NOT LEGALLY BINDING
What is the definition of a vulnerable adult
What is abuse
What are the types
Unable to protect themselves due to physical or mental reasons
Hard to make their wishes known
Acts that are designed to control another individual
Neglect Physical Emotional Sexual Financial
What are the main risk factors for abuse
Where do safeguarding issues most commonly occur
Age, being female Physical/learning disability MH problems Social isolation Desirable financial circumstances Ethnicity (lower in eastern families)
Own homes
Residential care homes
Nursing homes
What are the 4 types of restraint
Physical - bodily force
Mechanical - use of a device to restrict movement
Chemical - use of medication (sedatives)
Seclusion - supervised confinement and isolation
What is the Duty of Candour
Being open and honest about mistakes with relatives and other staff
