Ethics

Question 1

Who does the Adults with Incapacity Act 2000 apply to?

Answer 1

Managing adults 16 and over who lack capacity due to:

• Mental illness
• Learning difficulty or related condition
• Inability to communicate

Question 2

Explain Power of Attorney in relation to the Adults with Incapacity Act 2000

Answer 2

While the patient still has capacity, they give authority to another person (Granter) to deal with their property, financial or personal affairs

Question 3

Explain Welfare/Financial Guardianship (Part 6) in relation to the Adults with Incapacity Act 2000

Answer 3

A court order appointing a person or office holder a s guardian in relation to the patient’s property, financial affairs or personal welfare

Question 4

How does Welfare/Financial Guardianship (Part 6) in relation to the Adults with Incapacity Act 2000 apply to someone soon to be 16?

Answer 4

An order appointing a person or office holder in relation to a child becoming an adult within 3 months, but the order will not take effect until the 16th bday

Question 5

Explain Medical Treatment in relation to the Adults with Incapacity Act 2000

Answer 5

This is Part 5

This act allows you to have treatment if can’t give consent either permanently or temporarily

Question 6

Explain Section 47 in relation to the Adults with Incapacity Act 2000

Answer 6

Prohibits the used of force or detention unless it is immediately necessary and only for as long as necessary

Question 7

What is Article 5 of the European Convention on Human Rights?

Answer 7

Protects patients against arbitrary detention

Question 8

What is meant exactly by “lacking capacity”?

Answer 8

Cannot:

• Make decisions
• Understand decisions
• Communicate decisions
• Act on decisions
• Retain memory of decisions

Question 9

Who does the Mental Health Act 2003 apply to?

Answer 9

Any mental illness, personality disorder, learning disability “however caused or manifested”

Question 10

Who can use:

a) Emergency detention
b) Short term and compulsory treatment orders?

Answer 10

a) Any registered medical practitioner

b) Have to be an approved practitioner (undergone psychiatry training)

Question 11

What are the key points of an Emergency Detention Order?

Answer 11

Usually with consent of MHO but can proceed without
Max 72hrs
Patient is not already detained
If patient not in hospital, have 72hrs to get them there
NO right of appeal
Cannot give treatment unless emergency
Must be reviewed by approved medical practitioner asap

Question 12

What are the key points of an Short Term Detention Order?

Answer 12

Applied by AMP, required MHO consent
Authorises treatment
Lasts max 28days
Right of appeal to Tribunal and Mental Welfare Commission

Question 13

What are the key points of an Compulsory Treatment Order?

Answer 13

Application made by MHO and supported by 2 medical reports (one from an AMP)
Right of appeal, may have legal representation
Authorises treatment
Requires to have a tribunal hearing
Care plan made by MHO (residency and attendance)
Lasts up to 6mnths
Patient can be in hospital or community

Question 14

What is the Tayside Rapid Tranquillisation Policy for those not with typical anti-psychotic drug exposure?

Answer 14

Lorazepam 1-2mg oral

If unsuccessful, another dose IM

Question 15

What is the Tayside Rapid Tranquillisation Policy for those with significant typical anti-psychotic drug exposure?

Answer 15

Lorazepam 1-2mg oral +/- Haloperidol 5mg oral

If unsuccessful, can give IM Lorazepam or combine in separate syringes

Question 16

If giving Lorazepam and Haloperidol together as part of rapid tranquillisation treatment, what must you remember to do?

Answer 16

Check RR,HR,BP every 5-10mins for 1hr