Ethics 4 Flashcards
What is informed consent?
Informed consent is the process in which a health care provider educates a patient about the risks and benefits of a procedure, as the patient must be fully competent to make a voluntary decision to undergo the procedure.
What are the key elements in the legal doctrine of informed consent?
The Tort of battery Defence to the Tort of battery: Informed consent Express consent Implied consent Standard of care in informed consent Causation in informed consent Exceptions to informed consent
What is the Tort of battery?
Intentionally or voluntary bringing about an unconsented harmful or offensive contact with a person or things related to that person
When is the Tort of battery committed by a medical practitioner?
When a medical practitioner treats a patient without his/her informed consent. A patient has a right to determine what should or should not be done clinically to his/her body
Or when a nurse fails to warn the patient about any clinical feature of treatment, e.g risk of any clinical hazard/side effect
What is meant by the patient-centred approach of the tort of battery?
If the patient does not give their informed consent to the proposed medical treatment or procedure then the tort of battery has been committed
What is the defence to the tort of battery?
Informed consent allows a medical practitioner to treat a patient without fear of committing the tort of battery
When is the defence of informed consent to the tort of battery applicable?
- Patients consent is given voluntarily
- Patient must be capable of giving consent (have mental capacity)
- Consent must be informed (based on the required medical information about the proposed medical treatment)
What is the standard of care in informed consent?
A medical practitioner must disclose all relevant clinical information regarding the risk of any clinical hazards/side effects
The medical practitioner must demonstrate that the clinical information disclosed to the patient was in full compliance with a general and approved practice
What is the test of materiality?
Whether in the circumstances of a case, a reasonable person in the patient’s position would be likely to attach significance to the risk
Or the doctor is or should reasonably be aware that the particular patient would be likely to attach significance to it
What is an elective surgery?
A surgery that is scheduled in advance because it does not involve a medical emergency.
What is the standard of care in the informed consent of elective surgery?
A warning of any material risk in medical treatment or clinical procedure
The statistical frequency of the material risk is irrelevant
What is implied consent?
Refers to a situation in which it is assumed a person consented to something by his/her actions
-Means that although the person has not given verbal or written consent, circumstances exist that would cause a reasonable person to believe the other had consented
What is express consent?
Express consent is permission for something that is given specifically, either verbally or in writing
What are the exceptions to informed consent?
Emergency
Minors
Mental capacity
Why is emergency an exception to informed consent?
Informed consent can be waived in emergency situations if there is no time to obtain consent or if the patient is unable to communicate and no surrogate decision-maker is available
Why is being a minor an exception to informed consent?
Children under 16 need someone with a parental responsibility to consent for them
-Unless they are Gillick competent and they can consent for themselves
What does it mean when a child is Gillick competent?
That the child has sufficient understanding and intelligence to understand what is involved in the proposed treatment, including its purpose, nature, risks and effects, chances of success and other treatment options.
Having this means the child can themselves consent to a procedure
What is the legislation around mental capacity and informed consent?
Mental health act of 1983
-Mental Capacity Act of 2005
What is the mental capacity act of 2005?
Provides a statutory framework to empower and protect vulnerable people who are not able to make their own decisions. It makes clear who can make decisions, in which situations, and how they should go about this. It enables people to plan ahead for a time when they may lose capacity
What is the mental health act of 1983?
Is the main piece of legislation that covers the assessment, treatment and rights of people with mental health disorders. People detained under the mental health act need urgent treatment for mental health as they are at risk of harm to themselves or others