Informed consent

Question 1

What are the two meanings of informed consent?

Answer 1

1. Autonomous authorization

2. Institutional/policy rules of consent

Question 2

What are the benefits of promoting shared decision making?

Answer 2

1. Ensure pt has active role
2. Pt is informed
3. Dr protects pt’s interests

Question 3

What is the reasonable person standard?

Answer 3

Standard that a dr is required to disclose what a reasonable person would want or need to know to make an informed choice

Question 4

What is the professional standard?

Answer 4

When dr. relies on judgement about what colleagues would do in similar situations

Question 5

When is implied consent applicable?

Answer 5

When the patient cannot give informed consent, and there is no surrogate

Question 6

True or false: Implied consent provides physician with defense against battery, and may defend against charges of negligence

Answer 6

False–no protection against negligence

Question 7

What are the four rights set out by the patient self-determination act?

Answer 7

1. Right to participate in their healthcare
2. Right to accept or refuse medical treatment
3. Right to prepare an advance directive
4. The receipt of information on the providers policies that govern the utilization of these rights

Question 8

What are the four instances in which the Dr can disobey the pt’s wishes?

Answer 8

1. Pt lacks MDM capacity
2. Pt wants more than medical standard
3. Pt requests are unreasonable
4. Conscientious refusal by dr.

Question 9

Does medical decision making capacity = competence? Who decides this?

Answer 9

No–only the court can decide competence

Question 10

Can you have a pt that is competent, but lacks medical decision making capacity?

Answer 10

Yes

Question 11

Is the determination of capacity a continuum (degree), or a threshold (either/or)

Answer 11

Continuum

Question 12

What are the four aspects that a patient must have, in order to have medical decision making capacity?

Answer 12

1. Understand relevant info
2. Appreciate situation and consequences
3. Communicate choice
4. Deliberate rationally

Question 13

True or false: the mental capacity of patients who refuse low-risk, high-benefit treatment without which they face serious injury or death must be assessed

Answer 13

True

Question 14

True or false: it is likely that someone with schizophrenia, depression, dementia etc. lacks medical decision making capacity

Answer 14

False

Question 15

What is the “durable power of attorney”?

Answer 15

Document that identifies who will make decisions when pt lacks medical decision making

Question 16

What is substituted judgement?

Answer 16

“what would pt want”?