Medical Law - Consent

Question 1

Rules of Consent

Answer 1

Must be given by a competent person, voluntary and informed

Question 2

Competence

Answer 2

Mental Capacity Act - everyone over 16 has the right to make own decisions unless proven to lack capacity!

Question 3

MCA functional test for capacity is,,,

Answer 3

1) unable to understand relevant infor
2) unable to retain info for long enough to make a decision
3) unable to use or weigh info to make a decision
4) unable to communicate decision
Also these must be caused by an impairment or disturbance in the functioning of the brain!

Question 4

Doctors level of disclosure about treatment

Answer 4

Disclosure of information should be based on a level that is reasonable to patients. Scarman thought about the ‘prudent patient’ - would a patient attach a significance to the risk!

Question 5

What to do if a patient refuses to know information?

Answer 5

Accept wishes as far as possible but still provide enough information to make informed consent! If they still refuse explain inssues and describe consent may not be valid and record this fact

Question 6

When does consent need to be in writing

Answer 6

Only for fertility and organ donation!
But good practice to get written consent when treatment is serious. Must consider patients have been given the information they need and how well they understood it!

Question 7

What age can people give consent

Answer 7

People over the age of 16 can give consent (family law reform act)

Question 8

Gillick competentce

Answer 8

Provided child understands proposed treatment with sufficient maturity and intelligence they can give consent!
Gallic competent child can provide legally valid consent even in the face of parental opposition and without parental knowledge!

Question 9

Fraser Guideleines

Answer 9

Regarding contraception!

When a girl either refuses to tell parents or refuses to allow parents to be told it is justified if you follow 5 points

Question 10

5 Fraser Guidelines points

Answer 10

1) understand advice
2) can not persuade her
3) likely to have sex with or without contraceptives
4) physical or mental health likely to suffer without contraceptives
5) best interests to give them without parental consent

Question 11

Refusal of treatment

Answer 11

Young people have no right to refuse treatment
At 16 and 17 years old refusal can be overturned by the court but not parents
Under 16 refusal can be overturned by parents even if Gillick Competent!
Prudcent to obtain a court declaration if faced with a competent child who is refusing treatment!