Legal Aspects of Consent Flashcards
Consent to treatment means what?
Consent to treatment means person must give permission before they receive any type of treatment, test or examination:
- Clinician must explain what it is
- Consent from patient is needed regardless of procedure
- Principle of consent is important part of medical ethics and international human rights law
What are different kinds of consent?
- Implied or verbal agreement for non-invasive treatments
- Express consent for minor or routine investigations
- Written consent for procedures that involve higher risk such as surgery
What kind of consent is needed for non-invasive treatments?
Implied consent
What kind of consent is needed for minor or routine investigations?
Express consent
What kind of consent is needed for procedures that involved higher risk such as surgery?
Written consent
Examinations of intimate zones with lack of adequate consent can lead to what?
Accusations of indecent assualt
Examations or treatment without adequate consent can lead to what?
Accusations of common assualt
All intimate examinations require what?
A chaperone
Any consent must be informed consent, what does this mean?
- Meaning patient should be informed of practicalities of procedures, the benefits and risks involved and if they refuse
Describe how consent is obtained?
- Listen to patient and respect views
- Discuss diagnosis, prognosis and treatment
- Share with patients information they want or need to make decisions
- Maximise patients opportunities and ability to make decisions (autonomy)
- Respect patients decisions
Can doctors pressure patients to choose what they believe to be their best option?
Doctor must recommend option they believe to be best for patient, but must not pressure patient to accept (no coercion)
Does a doctor have to provide treatment that the patient requests?
If patient asks for treatment doctor believes to not be beneficial the doctor does not have to provide, but must explain their reasons to the patient
All decisions should be recorded where?
In medical records or on consent form
Why should you check if patients wish to go ahead with treatment even if they have previously consented?
- May have changed mind
- May have been material change in patients condition
Consent depends on what?
Consent depends on capacity:
- Only patients with capacity can consent
What are things that can impact capacity?
- Pain
- Impaired intellectual capacity
- Unconscious
- Communication difficulties
- Age
- Fear
- Confusion
- Effects of medication, drugs or alcohol
What are some methods to get around communication difficulties that inpact capacity and ability to consent?
- Next of kin
- Braille information leaflets/consent form
- Sign language
- Interpreter via phone or in person
How old do you have to be to have capacity to consent?
- In England and Wales child is someone who has not reached 18
- In Scotland, definition varies but in most situations is someone under 18, in some situations such as in children’s hearings and child protection orders a child is a person under 16
In Scotland, when can patients under 18 consent?
- Under 16 can consent if believed to have enough intelligence and understanding (Gillick competent)
- People aged 16 or 17 are presumed to have enough capacity to make their own decisions unless significant evidence suggests otherwise
When can consent be overruled in a young person in Scotland?
- If they refuse treatment which may lead to death or severe permanent injury can be overruled by Court of Protection
- Parents, but usually thought best to go through courts
What is capacity?
Can understand, believe, retain and weight the necessary information
Capacity is governed by what legislation in England and Wales, and in Scotland?
England & Wales - Mental Capacity Act 2005
Scotland - Adults with Incapacity Act 2000
In law, “incapable” means what?
- Incapable of
- Acting on decisions or
- Making decisions or
- Communicating decisions or
- Understanding decisions or
- Retaining the memory of decisions
- In relation to any particular matter due to mental disorder or inability to communicate because of physical disability
What are the principles of the Adults with Incapacity Act 2000?
- Principle 1
- Any action or decision taken must benefit person
- Principle 2
- Least restrictive option
- Principle 3
- Take account the wishes of person
- Principle 4
- Consultation with relevant others
- Principle 5
- Encourage the person to use existing skills and develop new skills
