Laws Flashcards
What does consent require?
- Patient must have CAPACITY to consent to intervention
- Patient must be appropriately INFORMED
- Must be given VOLUNTARILY - not under influence
Mental Capacity Act
- Presumption of capacity for adults aged 16 and over
- Person not to be treated as unable to make decision unless “all practicable steps to help him to do so have been taken without success”
- Right to make eccentric or unwise decisions
- All actions/decision under the Act for/on behalf of the person must be done or made in their BEST INTEREST
- Actions/decisions must be those that are least restrictive of basic rights and freedoms
Does the patient have capacity?
- Is the patient suffering from an impairment of, or a disturbance in the functioning of, the mind or brain?
- Does the disturbance/impairment make a person UNABLE to make a decision for himself, at the time?
Are they unable to:
a) understand information relevant to the decision
b) retain information
c) use or weigh up that info as part of a decision process
d) communicate their decision (by any means(
Re B
Adult refusal of treatment (life-prolonging)
Re C
Adult refusal of treatment - mental illness does not automatically mean they do not have capacity
Re MB
Patients may become temporarily incapable of making a decision
Montgomery
All risks should be weighed up and explained to an individual (side effects, small risks)
Gillick
Children <16 can consent to contraceptive treatment without parents if they have sufficient understanding/intelligence to weigh up risks
Fraser Guidelines
- <16 girl will understand advice
- Cannot persuade her to inform her to inform her parents
- Very likely to continue to have intercourse w/o treatment
- Without treatment/advice her physical/mental health is likely to suffer
Stephens v Avery
Confidential information cannot be disclosed
Bolam
Actions would have been followed by a reasonable body of medical men
Bolitho
Even if medical experts agree, a judge can overrule the decision if the opinion cannot withstand logical analysis
Wilsher
The trainee/learner is to be judged by the same standards as their more experienced colleagues. If other risks/factors could have caused the injury, then on the balance of probabilities the hospital was not liable as it was more likely that an alternate risk had caused the injury (blindness to baby)
‘But for’ test
To establish causation.
“But for” the negligence, would the harm still have occurred?
Balance of probabilities is used
Negligence
- They were owed a duty of care
- That duty of care was breached
- They have sustained an injury
- Which was caused by that breach of duty
Doctrine of necessity
Treatment is given without consent in emergencies
Power of attorney: Ordinary
Person makes decisions on financial affairs even when you have capacity (pt away on holiday or in hospital)
Power of attorney: Lasting
Covers decisions on financial affairs as well as health and care when capacity is lost or individual no longer wants to make decisions themselves
Power of attorney: Enduring
Has been replaced by LPA
When would you report to the coroner?
- Unknown cause of death
- Unnatural death e.g. murder
- Suspicious circumstances or history of violence
- Accidental or suicide
- Neglect is suspected
- Industrial disease is suspected
- Not seen by a doctor in the last 14 days
- During/shortly after detention by police/prison
- Under the Mental Health Act
- Within 24hours of hospital admission
- Could be linked to a medical procedure/surgery
Burke
Right to demand treatment even if doctors decide it is futile (advance directive)
Confidentiality can only be breached if
- Patient has given consent
- If disclosure is in the patient’s best interests
- To other members of the healthcare team
- It is required by law (statute or court proceedings)
- It is in the public’s best interest
Bland
Withdrawal of artificial nutrition due to Bland being in a vegetative state
Cox
Dr Cox was charged with attempted murder for injecting a terminally ill patient with PCl
Pretty
A terminally ill mother wanted help to die, but could not carry out the process alone so her request was denied.
Mrs B
Paralysed and put on a ventilator, but was competent so was able to have the ventilator turned off
Re: T adult refusal 1992
Right to withdraw and refuse medical treatment (Jehovah’s witness refused blood)
DNAR
Document signed by a doctor, only relates to CPR, legally binding
Advanced decision
Written and legally binding. Made when a patient has capacity to refuse future life-saving treatment when they lack capacity –> can’t demand treatment
Advanced statement
Can be written or verbal, not legally binding. This is made when a patient has capacity, but is only a request
