Peri-operative consent and capacity Flashcards
What requires consent and what specifically requires written consent?
- Any intervention or treatment requires consent
- However, written consent is not required by law but it is good medical practice
- Actions and words can imply consent (holding out your arm for cannulation)
What must consent be in order to be valid?
- Can be given any time before the intervention is initiated but it is an ongoing process throughout the patient’s time with you
- Information, including risks and alternative course of action, must be understood by the patient
- Conset must be given voluntarily
- The doctor providing the intervention must ensure that consent has been established
- Even if another staff member, with adequate training, has sought the consent
What is capacity?
The ability to understand, retain, weight up relevant information and communicate the decision
Read these important things to remember when taking consent
What is the difference between withdrawing and withholding support?
- Withdrawing
- All life-supporting measures are removed
- Withholding
- No acceleration in care
- *Both involve changing from maintaining life to comfort during the dying process
What are the clinical determinants of brain death?
You are an F1 doctor who has just started working on a paediatric ward. During the ward round, you see an 8-year-old boy with his parents, he suffers from West syndrome and has been involved in a research trial which involves regular EEG recordings. Although his parents have consented to him being involved in the trial, the boy interrupts saying he hates the ‘horrible head stickers’ and becomes visibly distressed when the trial is mentioned. What is the most appropriate course of action?
Raise your concerns with your consultant about the child’s obvious distress about being in the research
You are an F2 doctor working on your GP rotation when a 14-year-old girl, originally from Sierra Leone, comes to your clinic alone seeking contraceptive advice. She tells you she is sexually active and has a boyfriend who is 15-years-old. Under what circumstances should you give advice regarding contraception to someone under 16-years-old without parental consent?
- If advice and treatment is in the public’s interest
- If she is HIV positive with a transmission risk to the partner
- If she won’t tell her parents and will continue to have sex
- If she is doing well in school and is obviously intelligient
If she won’t tell her parents and will likely continute to have sex
- Dawn, a 14-year-old with learning difficulties, attends her GP surgery. After a practice meeting, it is deemed that Dawn lacks the capacity to make decisions about her own medical treatment. When making decisions on Dawn’s behalf, which of the following principles are most important?
- Discourage her invovlement in the decision making process due to her learning difficulties and age
- Consent may be given by one parent for the treatment that is in the patient’s best interests
- The decision which will make both her parents most happy
- If one parent consents to the treatment, it can be given to Dawn in any situation
- Both parents must consent to any decision made in Dawn’s best interests
Consent may be given by one parent for the treatment that is in the patient’s best interests
Describe consent in children
Describe consent in mental illness
Describe consent in transient/irreversible cognitive impairment
Describe consent with confidentiality
What are the only procedures which legally require written consent
- Fertility treatment
- Organ donation
What are the types of conset?
- Implied
- Holding arm out for venepuncture
- Explicit
