Ethics and law tutorial - consent Flashcards
Why is consent important from an ethical perspective?
- Respect for autonomy
- Benefits patients (more control, adherent)
- Establishes relationship of trust
- Respect for persons / dignity
- Legal + professional requirement
- Virtues - trustworthiness
What is meant by battery, negligence and assault in terms of consent?
- Battery - entirely absent or invalid (but adequate) consent
- Negligence - some consent but invalid + inadequate
- Assault - entirely absent or invalid, but adequate consent
What makes up valid consent?
- Information
- Voluntariness
- Competence
Also ‘continuing’ - patients should know they can change their minds
What does competence involve the ability to do?
To:
- understand relevant info
- retain relevant info
- weigh up relevant info
- communicate decision
PARQ
What information should be given to a patient to obtain valid consent?
- Procedure
- Alternatives
- Risks
- Questions
3 models
How much info is considered ‘adequate’?
- Professional practice standard - conforms to prof practice
- Reasonable/prudent person standard - hypothetical reasonable person
- Subjective standard - enables individual to make informed choice
What is meant by ‘voluntariness’?
- Patients must be able to refuse
- Patients must know that they are able to refuse
- Patients must be free from undue pressure
Can obtaining consent be delegated to someone else?
The task of obtaining consent can be delegated, if the doctor-in-charge is sure that the delegate: Is suitably trained and qualified; has sufficient knowledge of the procedure, including risks and benefits; understands, and agrees to act in accordance with, GMC guidelines on consent (2008)
Are signed consent forms useful, if not what is better?
A signed hospital consent form provides minimal evidence that the informed decision-making process was adequate
The best evidence of an adequate decision making process is a contemporaneous note
When is consent not possible or necessary?
When patient:
- not competent (-> best interests)
- poses serious risk to others if not treated/restrained
- declines “all” information
