Treatment in the Emergency Department Flashcards
What’s required for consent to be valid? What might be problematic in the ED?
Capacity + Information + Voluntariness
Capacity likely to be impaired in emergency situations affecting consciousness, although generally needing to treat urgently can influence voluntariness
What needs to be considered in ED for appropriate consent?
Facilitate capacity: pain relief, environment, timing, support
Give appropriate level of information
What’s proxy consent?
Possible under MCA when patient lacks capacity
Lasting power of attorney appointed in advance
Or court appointed deputy
Which ethical principle is undermined in emergency treatment?
Autonomy: part of respecting patient autonomy is requiring consent but situations arise whereby consent not possible
What’s the legal framework for treating without consent?
Under common law: the Doctrine of Necessity
Under MCA if patient lacks capacity treatment must be in their best interests
Patient can be detained under MHA with/without capacity but under specific conditions
What’s the basis of necessity (in emergency treatment)?
When an emergency situation arises and its not possible to find out a patients best wishes, you can treat them without consent if the treatment is immediately necessary to save their life or prevent serious deterioration, and is the least restrictive option for the patients future choices
Outline best interest decisions - under what law?
An act done, or decision made, for a person who lacks capacity must be done or made in their best interests
Mental Capacity Act
What are the specifics of best interest decisions?
Must consider:
Persons past and present wishes
Beliefs and values likely to influence decisions
Other factors likely to consider
Must not be based on:
Persons age or appearance
A condition/behaviour which might make others make unjustified assumptions about what’s in their best interest
Under the MCA when is restraint appropriate?
In order to prevent harm
Must be proportionate to likelihood of suffering harm and seriousness of harm
What is restraint?
Use or threaten to use force to someone who resists, or that restricts liberty of movement
What’s the deal with consent to treat children?
Competent child or
Parents - under Children Act
Mother or Father (if married to mother at time of childs birth, or registered on birth certificate, or by parental responsibility agreement with mother)
