Ethics of consent, treatment of young patients and confidentiality Flashcards
When can you treat an adult (+16) without consent?
Emergency
If AWI can be applied
MHA can be applied
When do you need to give whether someone can consent more thought?
Child/ young person (under 16) with limited capacity to consent
A competent adult; assumed competent unless shown to lack capacity
An adult (16+) with limited or no capacity to consent
What can occur with breaches of laws on consent?
Battery
Negligence
What is consent?
Agreement to do something or allow someone to do something to them
Can be withdrawal by the consented at any time with no penalties
Withdrawal of consent must be respected immediately
NON binding
Does consent need to be signed?
No; often implied
Patient can withdraw consent at any time without any reason
What is the GMC guidance on consent?
A competent adult must in advance agree to any treatment or investigation
A competent adult can refuse treatment or investigation (including life-saving ones) but cannot demand treatment
What are the basic rules on protecting the best interest of competent adults?
Doctor outlines the treatment options and lets the patient decide
Listen to people and respect their view about health
Discuss with them openly their treatment options and let them make their own free choices
How can we improve the patients’ capacity to consent?
It is our duty to maximise their opportunities and abilities to make choices for themselves
Capacity to consent may be impaired due to unspoken fears
Some people may require additional support
How can bias, stereotyping and discrimination be avoided?
You must not assume that a patient lacks capacity to make a decision solely because of their age, disability, appearance, medical condition, beliefs, apparent inability to communicate or the fact that they make a decision that you disagree with
How is capacity assessed?
Understand treatment options, weight up potential benefits, risks, burdens and side effects of options
Retain information provided
Weigh up, decide and communicate their decision
What are the requirements of valid consent?
Capacity (competence); ability to give or withdraw consent
Information; patient received enough information and understands the information
Voluntariness
What are the basic rules of treatment of children?
Parent/s must be consulted about their child’s treatment (unless absolute emergency)
It is assumed that parents make decisions in the best interest of the child, and must be consulted from moment of birth
Child’s consent should ideally be sought, even from toddlers
State must protect best interests of child, so can override parents wishes
Power can be devolved to others e.g. doctors, nurses, social workers
What is the most recent legislation in scotland surrounding treatment of children?
Children and Young People (Scotland) Act 2014
What occurs if parents disagree with the healthcare team?
Judge can assess the situation and override parent’s refusal of consent
What is the guidance surrounding capacity in under 16s in Scotland?
A person under the age of 16 shall have legal capacity to consent on his own behalf to any surgical, medical or dental procedure or treatment where, in the opinion of a qualified medical practitioner attending him, he is capable of understanding the nature and possible consequences of the procedure or treatment
When obtaining consent, the doctor must establish whether the child is legally competent to give consent
