ethico-legal stuff Flashcards
what should be considered when assessing what is in someones best interests? (4)
1) whether the person is likely to regain capacity
2) how to encourage and optimise the participation of the person in the decision
3) the past and present wishes/feeling/beliefs and values of the person and any other relevant factors
4) views of other relevant people
what are advance decisions/directives?
a document written at a time when a person is of sound mind, of that individual’s preferences with respect to medical treatment, should they later become unable to express those wishes directly
how does lasting power of attorney affect advance decisions ?
According to the Mental Capacity Act the perspective of any Lasting Power of Attorney has precedence over the written advance decision
how are lasting powers of attorney chosen ?
LPA are appointed by patients under the MCA before they lose their capacity, and can make decisions on their behalf.
the patient has capacity and LPA. who makes the decisions?
the LPA cannot make treatment decisions if the patient still has capacity
how to you make decisions when a patient lacks capacity? (4)
- make the care of the patient your first concern
- treat patients with dignity
- support patients in their decisions
- do not discriminate against patients
in what scenarios is disclosure required by law (breaking confidentiality)
- following an order made by a judge or presiding officer of a court
- in certain cases of ocmmunical disease when you must inform the local authority
- to prevent an act of terrorism
- to complete with statutory request made by a regulatory body she as the GMC
when do you need to break confidentiality to inform the police about a patient ? (2)
- gunshot wounds
- knife injuries (unless injury appears to be accidental or a result of self harm)
what is a DOL ?
a person is deprived of their liberty when they are not free to leave a place (like care home or hospital) and are under continuous supervision or control
what is required for DOLs?
- lack capacity (the person must lack the mental capacity to make decisions about their care and treatment, including where they live
- best interests: any restriction not he freedom must be in their best interests and the least restrictive way to ensure their safety
what are the key principle of DoLS ?
- least restrictive
- best interests
- review
- authorisation (care homes and hsotpiwl must apply to the local authority for authorisation before depriving person of their liberty)
what criteria should be used to assess whether to stop drugs in the elderly ?
STOPP-START Criteria
