perio 2

Question 1

Informed consent

Answer 1

a legal requirement whereby a person can be said
to have given consent based upon a clear appreciation and
understanding of the facts, implications and future consequences of an
action.

Question 2

How can consent be given ?

Answer 2

implied

written verbal

Question 3

Implied:

Answer 3

often seen as method of consent for simple procedures,

i.e. patient holding out arm to allow BP cuff placement

Question 4

Verbal:

Answer 4

common form of consent in healthcare institutions,
i.e. Nurse- is it ok if I place this BP cuff on your arm?
Patient - yes

Question 5

Written:

Answer 5

Signed and dated consent form

Question 6

Written Consent

Answer 6

Documentary evidence of what has been consented to verbally
- Must include procedure or possible procedures that are to take
place
i.e Diagnostic Laparoscopy +/- Laparotomy +/- Bowel Resection +/- Formation of
Stoma
- States Patient Name, DOB and MRN
- Is signed and dated by both doctor and patient/guardian
- Expires after 12 months
- Important to check local policy on consent forms (electronic,
scanned)

Question 7

What is valid consent?

Answer 7

1. Consent must be freely given
2. The person giving consent must have the legal capacity to give
   consent
3. Consent must be given from a position of being informed

Question 8

1. Consent must be freely given

Answer 8

• Patients must not be coerced into giving consent
• Valid consent cannot be obtained whilst the patient is
  under duress or sedation (including post sedation)
  i.e. “You must have this treatment, or you will be discharged
  from hospital”
  “I am the doctor/nurse and I know what’s best for you”.

Question 9

2. The person giving consent must have the legal capacity to give
   consent

Answer 9

• Intellectual incapacity (developmentally delayed/mentally ill)
• A person younger than 18yrs is legally considered to be a child
• NSW formally accepts >14yr for consent to medical/dental
  treatment
• Some adolescents (14-18yr) may wish medical treatment without
  their parent/guardian’s knowledge
• Ward of the State: treatment must be consented to by Minister in
  charge of the relevant government department

Question 10

3. Consent must be given from a position of being informed

Answer 10

• All of the information that is gathered and utilised to make an
  appropriate decision regarding treatment
• Explanation of proposed treatment
• Informed of risks and benefits
• Include alternatives to treatment
• Need adequate time for patient questions
• Have option to withdraw from treatment

Question 11

Lack of Consent

Answer 11

If consent is not given…
- Treatment given to a patient without either their or their
guardian’s consent is deemed to be battery
- The patient may be entitled to sue even if they do not sustain
an injury or loss

Question 12

Right to refuse treatment

Answer 12

• Patients have a right to refuse treatment
• Hospital has no authority to override patient’s wishes
• Hospital must seek intervention from Supreme Court of
  relevant state
  i.e. Jehovah’s Witnesses right to refuse blood transfusions

Question 13

Consent not Required

Answer 13

• If the patient is unconscious or is critically ill and will die if
  treatment is not rendered
• Parental consent is NOT required when the child is unconscious
  or critically ill and requires life saving treatment (duty of care)

Question 14

Three Phases of surgery

Answer 14

Sign in
Time out
Sign out

Question 15

Sign in

Answer 15

before the induction of anaesthesia

Question 16

Time out

Answer 16

before the incision of the skin

Question 17

Sign out

Answer 17

before the patient leaves the operating room