Ethics & Morals Flashcards
Describe consent
Every adult must be presumed to have the mental capacity to consent or refuse treatment, unless they are:
- Unable to take in or retain information provided about their treatment or care
- Unable to understand the information provided
- Unable to weigh up the information as part of the decision-making process
What are the three components of valid consent?
English law identifies three components of valid consent:
- Competency/capacity
- information(the patient has all relevant information to make an informed decision)
- Volition(the consent is given voluntarily)
Describe emergency treatment
An adult who becomes temporarily unable to consent due to, for example, being unconscious, may receive treatment necessary to preserve life. In such cases the law allows treatment to be provided without consent, as long as its in the best interests of that person. Medical intervention considered being in the persons best interests, but which can be delayed until they can consent, should be carried out when consent can be given. Exceptions to this are where the person has issued an advanced directive detailing refusal of treatment.
What are the forms of consent?
If patients agree to treatment and care, they may do so:
- Verbally
- In writing - before major operations that are high risk
- implying(by co-operating)
Equally they may withdraw or refuse consent in the same way. Verbal consent, or consent by implication will be enough evidence in most cases. Written consent should be obtained if the treatment or care is risky, lengthy or complex. This written consent stands as a record that discussions have taken place and of the persons choice.
Describe refusal of consent
- If a person refuses treatment, making a written record of this is just as important
- A record if the discussions and decisions should be made
- Legally, a competent adult can either give or refuse consent to treatment, even if that refusal may result in harm or death them themselves
- Nurses and midwifes must respect their refusal just as much as they would their consent. It is important that the person is fully informed and, when necessary, other members of the health care team are involved
Describe advanced directives
- The law and professional bodies recognise the power of advanced directives or living wills
- These are document made in advanced of a particular condition arising and show the persons treatment choices, including the decision not to accept further treatment in certain circumstances
- Although not necessarily legally binding, they can provide very useful information about the wishes of a person who is now unable to make a decision
Describe the consent of children
- If the person is under the age of 16(a minor), you must be aware of local protocols or legislation that affect their care or treatment
- Children of 16 or 17 are presumed to be able to consent for themselves, although it is considered good practice to involve
- Children of 16 or 17 are presumed to be able to consent for themselves, although it is considered good practice to involve the parents
- Parents or those with parental responsibility may override the refusal of a child of any age up to 18 years. In exceptional circumstances, it may be necessary to seek an order from the court
- Child minders, teachers and other adults caring for the child can not normally give consent
- Always seek advice when dealing with under 18s
Define confidentiality
Duty of confidence arises when one person discloses information to another in circumstances where it is reasonable to expect that the information will be held in confidence
This duty of confidence is derived from:
Common law – the decisions of the Courts
Statute law which is passed by Parliament:
- The Data Protection Act 1998
- The Human Fertilisation and Embryology Act 1990
- The National Health Service Venereal Disease Regulations (SI 1974 No.29)
- The Mental Capacity Act (2005)
- The Freedom of Information Act 2000 and Freedom of Information (Scotland) Act 2002
- The Computer Misuse Act 1990
- Confidentiality is a fundamental part of professional practice that protects human rights. This is identified in Article 8 (Right to respect for private and family life) of the European Convention of Human Rights
It is not acceptable for medical staff to:
- Discuss matters related to the people in their care outside the clinical setting
- Discuss a case with colleagues in public where they may be overheard
- Leave records unattended where they may be read by unauthorised persons
Define disclosure
Disclosure means the giving/sharing of information
Disclosure is only lawful and ethical if the individual has given consent to the information being passed on
Such consent must be freely and fully given
Consent to disclosure of confidential information may be:
- Explicit
- Implied
- Required by law or
- Capable of justification by reason of the public interest
Define the Caldicott principles
- Justify the purpose for using confidential information
- Don’t use personal confidential data unless absolutely necessary
- Use the minimum necessary personal confidential data
- Access to personal confidential data should be on a strict need-to-know basis
- Everyone with access to personal confidential data should be aware of their responsibilities
- Understand and comply with the law
- The duty to share information can be as important as the duty to protect patient confidentiality
