Medical Ethics

Question 1

Consent

Answer 1

Consent is when a patient gives them permission for something to happen

Question 2

Informed consent

Answer 2

Patient demonstrates they are aware of risks benefits and alternatives of the proposed topic

Question 3

Capacity

Answer 3

The ability of a patient to give consent

Question 4

What is capacity represented by

Answer 4

This is usually assessed by the patients understanding of what they are about to undertake

Question 5

Mental capacity act 2005

Answer 5

1. Can they understand the information given
2. Can they retain the information
3. Weigh up risks and benefits
4. Communicate their decision

Question 6

Under which circumstances is capacity temporarily compromised (4)

Answer 6

• alcohol or drugs
• a cute mental health illness
• being unwell
• having reduced consciousness

Question 7

Permanent compromise of capacity (3)

Answer 7

• dementia
• brain injury
• learning difficulty

Question 8

Medical proxy

Answer 8

Somebody nominated to make medical decisions on behalf of a patient if they are in a situation where they have long term cognitive impairment for example patients with learning disabilities

Question 9

Advanced directives

Answer 9

The term advance directive (increasingly being replaced by the term advance decision) means a statement explaining what medical treatment the individual would not want in the future, should that individual ‘lack capacity’ as defined by the Mental Capacity Act 2005.

Question 10

What are the 4 principals when answering a capacity question

Answer 10

1. Assumed they have capacity unless proven otherwise
2. Aware of risks and benefits + outcome
3. Poor decision doesn’t mean the patient lacks capacity
4. Capacity is situation dependant

Question 11

Informed consent (5)

Answer 11

• patient must have capacity
• aware of risks and benefits and likely outcome
• delivered in a way they can understand
• thinking time and opportunity to ask questions
• respect the patients autonomy

Question 12

Gillick competence

Answer 12

Children are able to consent to treatment if it’s in their best interest and they have the capacity to do so

Question 13

What are the three things patients must understand to be gillick competent

Answer 13

• nature of treatment
• risks/benefits
• alternative treatment

Question 14

What do the Fraser guidelines deal with

Answer 14

Sexual/contraception matters without parental consent for under 16s

Question 15

What are the 5 things the Fraser guide lines state

Answer 15

1. The patient has the maturity to understand
2. The doctor is not able to convince them to involve their parents in the decision
3. The patient is about to or will continue to have sexual intercourse
4. If their health (mental/physical) would suffer
5. If it’s in the child’s best interest

Question 16

What can a child do if they are gillick competent

Answer 16

If a child is gillick competent they are able to undertake a treatment

Question 17

What can children under the age of 16 not do

Answer 17

Children cannot refuse treatment that is deemed in their best interest even if they are deemed gillick competent

Question 18

What May be a temporary solution to refusal of treatment that is if best interest

Answer 18

• give bare minimum to bring them back to a reasonable state of health and then defer bigger decisions to a time where the appropriate person is spoken to