Treating people without consent Flashcards
Mental Health Act
A person can be detained for assessment and/or treatment for a mental disorder.
A person can be subject to a community treatment order.
The person must have a mental disorder as defined in the Act.
Person poses a risk to him/herself or others.
Treatment without consent can only be given for the mental disorder.
Safeguards including review panels and specific time limits.
Mental Capacity Act
Applies to persons age 16 and over who lack capacity
Guiding principle is that any decision must be in the best interests of the patient.
A valid advance refusal of treatment must be respected.
Someone with a lasting power of attorney can make decisions on behalf of the patient, including refusal of treatment.
Children Act
The child’s welfare is the paramount consideration
Someone with parental responsibility can consent to/refuse treatment
A competent child’s refusal can be overridden if a valid consent is obtained from someone with authority to consent
Parental responsibility in child health (who?)
Mother
Father if married to or jointly registered with the mother at the time of birth.
By a parental responsibility agreement with the mother
By a parental responsibility order of the court
How should/can you judge a patient’s best interests?
Encourage participation in the decision: consider whether it is likely the person will have capacity at a later time, and when that might be, also encourage the patient to participate as fully as possible.
Consider criteria for best interests, and consult views of others - either people named by the patient, those involved in the patient’s care, lasting power of attorney or deputy appointed by the court.
Criteria for best interests
Consider the person’s past and present wishes and feelings.
The beliefs and values that would influence the patient’s decision if they had capacity
other factors they would consider if they were able to do so.
Define incapacity
When a person is unable to:
- understand the information relevant to a decision
- retain the information
- use or weigh information as part of the process of making the decision
- communicate thier decision
N.B. The fact that a person is able to retain the information relevant to a decision for a short period does not prevent them from being regarded as able to make the decision.
Who should be consulted when deciding a patient’s best interests?
Anyone named by the person as someone to be consulted
Anyone involved in caring for the person
Anyone with a lasting power of attorney
Deputy appointed for the person by the court.
Role of a lasting power of attorney
A person/patient when competent can confer authority to another so that they can make decisions about all or any specified matters of personal welfae if the person becomes incompetent.
Process of conferring this authority must be properly registered.
The person with power of attorney is able to make decisions about giving or refusing consent to treatment. Also incudes decisions about where the person may live, giving directions about medical care
When is an advanced refusal not valid?
If the person has withdrawn the directive (and has capacity)
Has given someone power of attorney with regards to treatment involving the advanced refusal
If the person has done anything inconsistent with the advance decision
Treatment is not specified in the advanced refusal
There are grounds to believe that there are circumstances which were not anticipated by the person that owuld hve made a difference to the decision.
Requirements for an advanced refusal of life-sustaining treatment
Must be in writing
Must be signed by the patient
Signiaturemust be witnessed
Must be a specific statment made stating the advance deicison applies to the specific treatment even if life is at risk
Statement must also be signed by the patient and witness.
When can the court make a care order or supervision order
If the court believes the child is suffering or likely to suffer significant harm.
Harm of likelihood of harm is due to the care given to the child, or not what would be reasonable to expect a parent to give.
What is Gillick competent
Required for valid consent in children under 16.
Child must have sufficient intelligence and understanding to be able to understand their illness, the proposed treatment, its side effects and complications.
