Ethics - giving patients a voice

Question 1

What is consent?

Answer 1

Method which we respect patient autonomy
Process which patients are given information to enable them to decide on treatment
Ethical issue and legal requirement

Question 2

What are the elements of a valid legal consent

Answer 2

information
Capacity
Voluntariness
Decision

Question 3

Why may the practitioner be sued for battery?

Answer 3

When patient has given no consent
Patient tricked into giving consent
Patient has refused consent
Patient only consented to one treatment but have now given more

Question 4

When can negligence occur?

Answer 4

when dont give the patient adequate information

Question 5

What is meant by having capacity

Answer 5

A patient is able to understand what is involved in the decision to be taken
This doesnt depend on a person’s age or status

Question 6

Which people are presumed competent

Answer 6

Adults

Children over 16

Question 7

What about children <16?

Answer 7

are not presumed competent but may prove to be so under Gillick competence

Question 8

How do we assess capacity?

Answer 8

Mental capactiy act 2005
Person lacks capacity if at the time the decision needs to bt made they fail:
To understand the information relevant
To retain the information relevant to the decision
To use or weigh the information
To communicate the decsion

Question 9

What is meant by voluntariness?

Answer 9

The patient’s consent must be freely and voluntarily given
it is impossible for the patient to be competent and informed but to be prevented from giving free consent because of coercion that is improper pressure or undue influence

Question 10

In regards to voluntariness, when is consent not valid?

Answer 10

Where a patient is:
Unduly influenced
coerced by deception
Coerced by non-disclosure 
Coerced by manipulation of information

Question 11

What exceptions are there to consent?

Answer 11

Necessity/emergency
Implied consent 
Patient incapable of giving valid consent 
patient waiver 
Therapeutic privilege 
Mental health act

Question 12

What are the 3 GDC rules on consent

Answer 12

3. 1 You must obtain valid consent before starting treatment, explaining all the relevant options and possible costs
4. 2 You must make sure that patients understand the decisions they are being asked to make
5. 3 Must make sure patients consent remains valid at each stage of investigation or treatment

Question 13

GDC rule 3.1.1

Answer 13

Make sure have valid consent before starting any treatment

Question 14

GDC 3.1.2

Answer 14

Documentation
document the discussions
Discussions that take place that determines whether the consent is valid

Question 15

GDC 3.1.3

Answer 15

Find out what your patient wants to know as well as what you think they need to know

Question 16

GDC 3.1.4

Answer 16

Check and doccument that patients have understood the information you have given

Question 17

GDC 3.1.5

Answer 17

Patient’s can withdraw their consent at any time, refuse treatment or ask for it to be stopped after it has started
Must follow their wishes
Explain the consequences or risks of not continuing and ensure the patient knows they are responsible for future problems