Legal and Ethical Issues Flashcards
What are the 4 principles of biomedical ethics?
- Respect for autonomy
- Beneficence
- Non-maleficence
- Justice
What is meant by respect for autonomy?
Respecting the decision-making capacities of an autonomous person
What does respect for autonomy enable individuals to do?
Make reasonable informed choices
What is meant by beneficence?
Balancing the benefits of treatment against the risk and costs
What is ensured in beneficence?
The HCP acts in a way that benefits the patient
What is meant by non-maleficence?
Avoiding the causation of harm
What does non-maleficence mean in a practical sense?
All treatment involves some harm, even if minimal, but the harm should not be
disproportionate to the benefits of treatment
What is meant by justice?
Distributing benefits, costs, and risks fairly
What is meant by mental capacity?
A person’s ability to make their own choices and decisions
How is mental capacity judged under UK law?
According to the specific decision to be made
What is the result of mental capacity being judged according to the specific decision to be made?
A person may have sufficient capacity to make simple decisions, but not more complicated ones
What should be done in order for a patient to consent?
Staff should make an assessment of whether a person does or does not have capacity to consent to care or treatment
What are the 5 main principles of the MCA?
- Presumption of capacity
- Right for individuals to be supported to make their own decisions
- Should not be assumed that someone lacks capacity because their decisions seem unwise or eccentric
- All decisions should be made in patients best interest
- If someone lacks capacity, all options should be considered before a decision is made, and the option chosen should be the least restrictive of their basic rights and freedoms
What important question should be asked when determining capacity?
Does the patient have an impairment/disturbance of the mind or brain affecting how it works
What might cause an impairment/disturbance of the mind or brain affecting how it works?
- Dementia
- Learning disability
- Mental illness
- Delirium/unconscious
- Stroke
- Alcohol/drugs
- Head injury
- Neurological disorder/long term brain damage
What should be considered if a person does have an impairment/disturbance of the mind or brain?
Does that mean the person is unable to make the decision at the time it needs to be made
What factors must be considered to provide evidence that someone lacks mental capacity?
If the patient cannot demonstrate 1 of these, they are deemed to not have capacity;
- Understand
- Retain
- Use
- Communicate
Give 5 examples of when a patient’s capacity may be questioned?
- Patient refuses intervention
- Patient wants to go home with no support, but cannot cope
- Puts self at risk, and appears to be unaware of own limitations
- Patient is confused and does not answer questions appropriately
- Family members report concerns over patient’s cognitive state
What is the ICF Checklist?
A practical tool to elicit and record information on the functioning and disability of an individual
What should be done in the absence of mental capacity?
Employ decision making (best interests)
How can a patient’s best interest be established?
By considering;
- Is the person likely to regain capacity, and when?
- Maximise participation in process
- Past and present wishes of person
- Beliefs, values, and other factors
- Views of carers and other nominated/appointed persons
What must you not base a best interest decision on?
Age, appearance, or unjustified assumptions based on their condition
What do you need to document when making a best interests decision?
Clear and objective reasons as to why you are acting in the person’s best interests
What provisions were made in the Mental Capacity Act (2005)?
- Advance directive to refuse treatment (ADRT)
- Lasting power of attorney (LPA)
- Independent Mental Capacity Advocate service (IMCA)
- Court of Protection