Patient consent Flashcards
What is autonomy?
Respecting a persons’ views (the right or condition of self-government)
- its my body
- being self-governing from own values
- making mistakes and living with them
- absolute
for a legal stand point autonomy means we are responsible for our own actions
What is non-maleficence and what does it do?
means “do no harm”
this protects the patient
- best person to do this is the patient
What is an example of battery in terms of the legal significance of consent?
bodily integrity- touching someone without consent = non-concentual touching
What is an example of negligence in terms of the legal significance of consent?
professional competence- if you obtain consent for a procedure which the patient does not know all the information about, such as the side effect and potential risks
What are the legalities around battery ?
- just gives right to veto treatment
- non-consensual touching = civil (and potentially criminal
- even if the patient is not harmed or has benefitted
What are the legalities around negligence?
- more like the ethical doctrine of consent
- patient must prove that they wouldn’t have consented if they has known the risks
patient must have been harmed
What does a doctor need to consider when asking for consent from a patient regarding a procedure?
- information- needs to ensure patient knows all the information
- competent- need to assess individual to ensure they are capable of making an informed decision
- voluntary- the decision needs to be made by them, and not influenced by someone else
- decision- a decisions needs to have been communicated
What does the information aspect of gaining consent include?
it needs to be sufficient- including side effects, risks, alternatives e.g. no treatment
needs to be communicated effectively
A balance of the information provided needs to be struck, as you don’t need to inform of minor and low risk side effects
- if it is not balance this could impact voluntariness
What does the competence aspect of gaining consent include?
Competence is related to autonomy, and is not related to age or status but is assessed at an individual level.
For a patient to be competent they must be able to understand the information you are providing to them and therefore be able to link the complexity of the decision to the consequences to ensure they are making an appropriate choice for them
To assess competence the mental capacity act of 2005 is used. What does it include?
- understand- individuals needs to be able to fully understand the information you are providing to them
- retain- they need to be able to recall the information
- weigh info- they need to balance up the benefits vs risks to ensure they are making an informed decision
- they need to be able to communciate a decision
What does the voluntariness aspect of gaining consent include?
it is vital that persuasion doesn’t tip over into coercision
Absence of coercision
- this can be subtle (giving insufficient information about the options) or unsubtle (linking in one form of treatment as a condition of another)
the is a possible undue influence that can undermine autonomy
What does the decision aspect of gaining consent include?
This can be “yes” or “no”- if the information, voluntariness and weighing up are satisfied by the doctor, then the final decision of the patient needs to be respected, even if it isn’t the choice the doctor would have made
What are the additional rules for an adult lacking capacity?
- advanced directive
- appointed proxy
- best interests
What happens if a child is under the age of 16?
For patients under the age of 16, their competence needs to be assessed on an individual basis
What are the exceptions to consent?
- emergency treatment / necessity
- incompetent patients
- patient waiver
- therapeutic privilege
- public health requirements
- implied consent
There is no legal requirement that consent should be hand written but it is prudent to do so
