Session 1: Consent, capacity and refusal in adults Flashcards
What are the exceptions to consent
emergency, waiver, implied and best interests
what does emergency mean (in terms of exceptions to consent)
there is no time to ask so must act in best interests of the pt
what does implied mean (in terms of exceptions to consent)
consent is implied through patients actions
what does waiver mean (in terms of exceptions to consent)
some patients dont want to hear the details and just want treatment to commence
what does best interests mean (in terms of exceptions to consent)
if it is not possible to gain consent (e.g unconscious, dementia) or they lack capacity, the doctor must act in the best interests of the paient
what are the legal principles for consent and refusal
law requires pts to consent to any intervention, and patients with capacity have an absolute right to refuse to consent even if it is not in their best interest (or may lead to their death).
acting without consent can lead to criminal offence (assault and battery) or civil action from patient (claim for damages)
what do people need to be to give valid consent
competent
what should competent people be able to do
- understand the info
- retain the info
- use the info to make a decision
- communicate the decision
what is competence (not definition)
decision specific
what are some comptetence presumptions
adults (16+) assumed to be competent unless evidence suggests otherwise.
children (<16) assumed to lack comptenece unless evidence suggests otherwise.
what to do if in a coercive environment
take patient aside and the intervention should be discussed with them alone
what do competent patients have the right to
absolute right to refusal
what happens if the patient fails to meet any of the criteria for competence
they cannot grant valid consent so the doctor should act in the best interests of the patient
when can someone grant consent on behalf of another adult lacking capacity
if they have been granted specific legal authority by the court of protection
