Legal aspects of consent

Question 1

What is consent to treatment?

Answer 1

a person must give permissionbefore they receive any type of medical treatment, testor examination.

Question 2

Expressions of consent?

Answer 2

Implied or verbal agreement for non invasive treatments e.g. blood pressure, ECG
- obtained for minor interventions

Question 3

When should written consent be obtained

Answer 3

for procedures that involve higher risk e.g. surgical intervention

Question 4

Examination of intimate zones with lack of adequate consent renders the practitioner…

Answer 4

practitioner liable of indecent assault.

- have someone in with you !!!! chaperone.

Question 5

Common assault may constitute if..?

Answer 5

There is examination or treatment without appropriate consent or authority is an invasion of privacy

Question 6

Informed consent - what is it

Answer 6

The patient/individual should be informed of the practicalities of procedure, benefits/risks of procedure and benefits/risks if procedure not done or refusal of treatment.

Question 7

How is consent obtained as a practitioner? (5)

Answer 7

• listen to patients and respect their views about their health
• discuss with patients their diagnosis, prognosis, treatment
• share with patients the information they want or need in order to make decisions
• maximise patients’ opportunities, and their ability, to make decisions for themselves- autonomy
• respect patients’ decisions

Question 8

Doctor must not..?

Answer 8

not put pressure on the patient to accept their advice-no coercion.

Question 9

Recording decisions

Answer 9

use the patient’s medical records or a consent form to record the key elements of your discussion with the patient
- includes info discussed, requests made, audio given to patient

Question 10

Reviewing decisions?

Answer 10

Before beginning treatment, you or a member of the healthcare team should check that the patient still wants to go ahead and respond to any new or repeated concerns or questions they raise

Question 11

When is it important to review decisions?

Answer 11

Significant time has passed since the initial decision was made.

There have been material changes in the patient’s condition, or in any aspect of the proposed.

Question 12

What is capacity? consent is.. ?

Answer 12

directly dependent upon capacity.

Question 13

An individual’s capacity to make particular decisions may fluctuate or be temporarily affected by factors such as?

Answer 13

pain, fear, confusion or the effects of medication/illicit drugs/alcohol.

Question 14

Assessment of capacity must be?

Answer 14

time and decision-specific.

Question 15

Obstacles to capacity? (5)

Answer 15

Impaired intellectual/mental capacity
Intoxication (drugs or alcohol)
Unconsciousness - illness/trauma
Communication difficulties-hearing impaired, mute, language
Age

Question 16

Making decisions about treatment and care for patients who lack capacity is governed in England and Wales by what act? In Scotland?

Answer 16

Mental Capacity Act 2005, and in Scotland by the Adults with Incapacity (Scotland) Act 2000

Question 17

Principles of the AWIA act? principles 1-5?

Answer 17

Principle 1 – any action or decision taken must benefit the person
Principle 2 - least restrictive option
Principle 3 - take account of the wishes of the person
Principle 4 - consultation with relevant others
Principle 5 - encourage the person to use existing skills and develop new skills

Question 18

What is Power of attorney ?

Answer 18

This is a means by which individuals, whilst they have capacity, can grant someone they trust powers to act as their continuing (financial) and/or welfare attorney.

• ONE OR MORE PERSON CAN BE APPOINTED
• must be registered with the public guardian

Question 19

If a person does not have the capacity to make a decision about their treatment and they have not appointed a lasting power of attorney - what happens?

Answer 19

the healthcare professionals treating them can administer treatment if they believe it’s in the person’s best interests.

-Clinicians must take reasonable steps to discuss the situation
May need to go to court if agreement can’t be reached

Question 20

Impairment by drugs/alcohol or unconsciousness (2)

Answer 20

• if possible wait until the patient has sobered up/regained consciousness before commencing treatment.
• In a life-threatening situation, healthcare professionals may act on the behalf of the patient to perform a procedure in their best interest

Question 21

Communication Difficulties in individuals (4)

Answer 21

• speak with next of kin
• Braille information leaflets/consent form
• Sign language
• Interpreter via telephone or in person

Question 22

In Scotland the definition of a child varies

Answer 22

under 18 in most situations, can be under 16 years of age in some context (ie children’s hearings and protection disorders)

Question 23

People aged 16 or over are?

Answer 23

entitled to consent to their own treatment. This can only be overruled in exceptional circumstances.

Question 24

Children under the age of 16 can consent to their own treatment if they are believed to..?

Answer 24

have enough intelligence, competence and understanding to fully appreciate what’s involved in their treatment - Gillick competent.

Question 25

What is Gillick competence?

Answer 25

whether or not a child is capable of giving the necessary consent will depend on the child’s maturity and understanding and the nature of the consent required. The child must be capable of making a reasonable assessment of the advantages and disadvantages of the treatment proposed, so the consent, if given, can be properly and fairly described as true consent

Question 26

When consent can be overruled in the young person? (2)

Answer 26

If a young person refuses treatment, which may lead to their death or a severe permanent injury, their decision can be overruled by the Court of Protection -the legal body that oversees the operation of the Mental Capacity Act (2005).
- The parents of a young person who has refused treatment may consent for them, but it’s usually thought best to go through the courts inthis situation.

Question 27

For consent to be valid, it must be?

Answer 27

voluntary and informed, and the person consenting must have the capacity to make the decision.

Question 28

What does voluntary mean?

Answer 28

the decision to either consent or not to consent to treatment must be made by the person, and must not be influenced by pressure from medical staff, friends or family

Question 29

What does informed mean?

Answer 29

the person must be given all of the information about what the treatment involves, including the benefits and risks, whether there are reasonable alternative treatments, and what will happen if treatment does not go ahead

Question 30

What does capacity mean?

Answer 30

understand, retain and believe the information given to them and can use it to make an informed decision