Safeguarding Pt's rights Flashcards
Who makes a decision on behalf of a Pt?
Before MCA the Dr made the decision based on their best interest. Now the Pt has AUTONOMY and the courts has a role
What is the MCA 2005?
AUTONOMY and FREEDOM of an individual gives them the right to think and believe for themselves, making choices that define their personality and existence allowing the to learn from the consequences of their mistakes.
It deals with the temporarily or permanently incapacitated to define capacity and the Pt’s best interests which are protected by the criminal law.
How is autonomy maintained in a state of incapacity?
Through advanced directives, substituting decision making to a nominee or through court of protection.
What is in the patient’s best interests?
To chose the least restrictive option to support and enable the Pt. Always presume capacity until proven and unwise decisions do not mean incapacity, but repeatedly inappropriate decisions should be investigated.
When does a Pt lack capacity?
When they are unable to understand, retain, consider and conclude the information provided to make a decision for themselves due to an impairment or disturbance of the brain, whether permanent or temporary. Each decision is specific to the situation as a greater understanding is required for a higher level of serious consequences.
What if incapacity is thought to be reversible?
It is in the Pt’s best interests to wait if that is possible.
What is the DOCTRINE OF NECESSITY and what does it allow a HCP to do?
Can treat anyone who lacks capacity in order to save their life, limb or eye sight or to prevent deterioration. Must be justified by the determinator (anyone making a decision for the Pt) as acting in their best interest.
What should be considered when determining a Pt’s best interests?
Is it possible to wait for the Pt to regain capacity?
Maximum Pt involvement with support
Consider wishes, beliefs and values of Pt as far as possible
Consider the views of any nominee
Must not be motivated to bring about death in regards to life saving treatment.
What is the hierarchy (top to bottom) of people involved in decision making?
Pt through an advanced directive
Lasting power of attorney
Court of protection
Determinator for Pt’s best intersts
What is an advanced directive?
A legally binding document that is made when a Pt has capacity to specify conditions for withdrawing treatment or how aggressive actions should be to sustain life. Cannot make demands that will not provide benefit.
What if an advanced directive cannot be found?
Must attempt to find one if it is suspected but preserve life in the meantime. Court of Protection will ultimately decide if their is no advanced directive.
What is a Lasting power of attorney?
A proxy chosen by a pt to make decisions on their behalf regarding health, wealth and property. Must be registered and over 18. They can be restricted to the decisions they can make and cannot pass on the responsibility.
What does the Court of Protection do?
Deals with decision making for incapacitated. They remain objective, impartial and logistic to decide in the Pt’s best interests. They can make one off decisions, appoint duties or call for longterm monitoring.
