Mental Health and Consent (Law 3)

Question 1

Capacity

Answer 1

person’s legal ability to exercise his or her legal rights

Question 2

Criteria for existence of informed consent:

Answer 2

• Capacity
• Given freely
• Enlightened

Question 3

Defects of consent (invalid consent)

Answer 3

Fear, underpressure or Error

Question 4

2 requirements to the emergency exception to obtaining informed consent:

Answer 4

If the person’s life is in danger/intergrity is threatened AND consent cannot be obtained in time in order to avoid this threat to person’s life/bodily integrity.

Question 5

Issues for which patients have a right to information include:

Answer 5

The condition of their health
Prognosis
Tx options
Consequences and risks associated with a given tx.

Question 6

The Duty to inform: sign a document (waiver)

Answer 6

NOT ENOUGH, caregivers must ensure patient understand, received all relevant info and opportunity to ask/receive answers.

Question 7

Motion for tx and/or placement:

Answer 7

Superior court

Question 8

Motions for confinement in an institution OR for psychiatric evaluation:

Answer 8

Court of Qc

Question 9

Must prove to uuthorization for Tx by the court that:

Answer 9

Person do not have capacity to consent

Pt best interest

Question 10

Confinement in an institution: General principles

Answer 10

• Exceptional measure

- Serious and Immediate danger to themselves or others.

Question 11

Assessment of dangerousness

Answer 11

• Immediate or present short term (doubt is not a real danger)
• Must be such that it justify to maintain his confinement. (fact that pt may become again dangerous after leaving the hospital is not sufficient to constitute danger)

Question 12

Type of Forced confinement:

Answer 12

Preventive
Temporary
Motion for confinement

Question 13

Preventive confinement:

Answer 13

• danger to himself or to others
• Physician order (court order is NOT REQUIRED)
• Danger GRAVE and IMMEDIATE
• Possible assistance from peace officer

Question 14

When obtain a court order enxtending the ‘‘preventive confinement’’ to:

Answer 14

a ‘‘temporary confinement’’ (for the psychiatric assessment)

Question 15

In the event that the person accepts to be examined, it must be carried out within

Answer 15

24 hours after be has been taken in charge by the institution

Question 16

Temporary confinements:

Answer 16

• danger to himself or to others
• COURT ORDER REQUIRED
• Obtain if pt refuses to be evaluated by psychiatric

Question 17

Duration of confinement:

Answer 17

30 days (less if not necessary)
Released as soon they are not anymore dangerous to themselves or to others.

Question 18

Receiving the diagnosis of mental illness is sufficient to a motion for confinement

Answer 18

IT IS NOT SUFFICIENT.

Question 19

Renewal of confinement: After the expiration of 30 days period, it is possible to extend the confinement for a maximum of

Answer 19

a maximum of 90 additional days.

Question 20

For renewal of confinement: We need a evaluation done by

Answer 20

TWO NEW PSYs at the latest 48 hours before the expiry of the 30 days period.

Question 21

Right of the person under confinement:

Answer 21

• right to counsel
• right to appeal their decisions to Tribunal Administratif du Qc or Court of Appeal
• Right to communicate with outside persons (thrid parties) unless valid medical reason
• Right to see the application for confinement

Question 22

Case: Charles Le Moyne c. E.(F.)

Answer 22

• Brought to hospital by police, acting in a hostile manner and accusing to hide a corpse in is appartment.
• Insufficient to lead to conclusion he represent a danger to himself/others to a confinement order.

Question 23

Case: CSSS Cote-de-Gaspe c. P.(C.)

Answer 23

• Hospital seeking to renew her confinement order after 2 back-to-back 30days confinement.
• Lack of insight and judgement, with irritability and persecution complex.
• Motion dismissed. bc prior behaviour does not justify, danger must be present in short/medium term. Do not see any sign of danger.

Question 24

Case: Hopital Maisonneuve-Rosemont c. H.(M.)

Answer 24

• Refuse to take antipsychotic medication via injection

- MH’s refusal is maintained bc does NOT mean a person lacks legal capacity (capable and right to refuse/accept tx)

Question 25

Implied consent:

Answer 25

patient conduct (tendre le bras pour une PV)

Question 26

Expressed consent:

Answer 26

Verbally give the consent.

Question 27

Proxy consent:

Answer 27

a consent granted by a thrid party designated by the incapable person (when capable) to make decisions on his behalf.

Question 28

Disclosure is:

Answer 28

The process by which the healthcare professional tells a client of an adverse event that has affected him.

Question 29

Obligation is:

Answer 29

behaviour perform to permit the exercise of the right another.

Question 30

Right is

Answer 30

claim or privilege to which one is justly entitled, morally or legally.

Question 31

Who ultimately enforces legal rights?

Answer 31

The state (compels individuals to behave in certain ways)

Question 32

Moral rights

Answer 32

Moral right is not supported by societal norms but by the ethical principles of autonomy, beneficience, and non-maleficience.

Question 33

If informed consent is not given for a procedure, what the result for the nurses/professionnals, if their is plaintiff?

Answer 33

Legal liability for negligence.

Question 34

Advance directive:

Answer 34

document specifying patient instructions for care, should he or she become incompetent. (living will)