Legal aspects of consent

Question 1

What is consent?

Answer 1

Consent to treatment means a person must give permissionbefore they receive any type of medical treatment, testor examination

Question 2

What is informed consent?

Answer 2

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 3

What is the doctor’s role in the patient/doctor relationship?

Answer 3

The doctor uses specialist knowledge, experience and clinical judgement, alongside the patient’s views and understanding of their condition to identify best investigations or treatments for the patient

Question 4

What should a doctor do if the patient requests a treatment that the doctor believes would not be of benefit?

Answer 4

They do not have to provide the treatment. However, they should explain their reasons to the patient, and explain any other options that are available, including the option to seek a second opinion

Question 5

Should we record patient decisions?

Answer 5

Yes
You must use the patient’s medical records or a consent form to record the key elements of your discussion with the patient

Question 6

What factor on the patient side is consent dependent on?

Answer 6

Capacity

Question 7

What factors may cause capacity to fluctuate?

Answer 7

Pain
Fear
Confusion
Medication
Illicit drugs
Alcohol

Question 8

What are some obstacles to capacity?

Answer 8

Impaired intellectual/mental capacity
Intoxication
Unconsciousness
Communication difficulty
Age

Question 9

What legislation governs making decisions about treatment and care for patients who lack capacity in Scotland?

Answer 9

Adults with Incapacity (Scotland) Act 2000

Question 10

What is Power of Attorney?

Answer 10

Means by which an individual with capacity may grant someone they trust powers to act as continuing financial and/or welfare attorneys

Question 11

How are powers of attorney registered?

Answer 11

With the Public Guardian

Question 12

How do we obtain consent when there is impairment from drugs or unconsciousness?

Answer 12

Ideally wait until patient is sobered or conscious
In a life threatening situation healthcare professionals may act on behalf of the patient to perform a procedure in their best interest

Question 13

What are some ways to overcome communication difficulties?

Answer 13

Next of kin
Braille info leaflets or consent form
Sign language
Interpreter via telephone or in person

Question 14

What age must a child be to consent to their own treatment?

Answer 14

16
Under 16’s can consent if they are believed to have enough intelligence, competence and understanding to fully appreciate the treatment (Gillick competence)

Question 15

What are the Fraser guidelines?

Answer 15

The Fraser guidelines refer to the guidelines set out by Lord Fraser in his judgment of the Gillick case in the House of Lords (1985), which apply specifically to contraceptive advice

Question 16

When can consent be overruled in a young person?

Answer 16

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)

Question 17

What 3 criteria must consent have to be valid?

Answer 17

Voluntary
Informed
Capacity