Week 10: Informed consent

Question 1

Describe informed consent

Answer 1

The voluntary agreement of an individual, or his or her authorised representative, who exercises free power of choice, without undue inducement or constraints or coercion to participate. They must have sufficient knowledge and understanding of the nature of the research, including risks, benefits, and requirements.

Question 2

What is meant by ‘informed’

Answer 2

Disclosure of appropriate information, including the the treatment, what is involved, risks and benefits, and alternative options

Question 3

What is meant by ‘consent’

Answer 3

• voluntary
• not coerced or induced
• free from threat of abandonment
• time allowed to make a decision
• specific, not blanket
• need to ensure the person giving consent is capable

Question 4

Why is informed consent important for client rights?

Answer 4

• it is the right of clients to be informed
• gives them autonomy/self determination
• they have the right to refuse treatment

Question 5

What other principles are involved in informed consent?

Answer 5

• justice (equal treatment)

- non maleficence/beneficence (do no harm)

Question 6

Why is informed consent important for collaboration?

Answer 6

• participant needs to be involved, educated and willing to participate in therapy
• we respect our clients as decision makers

Question 7

Discuss full disclosure

Answer 7

• can be virtually impossible
• adequate disclosure is determined by the professional community
• doctor knows best is a problematic approach to take

Question 8

What is the reasonable person rule?

Answer 8

When thinking about legal requirements and disclosure:

• need to think about what a reasonable person would consider significant in making a treatment decision
• includes inherent potentials and hazards of proposed treatment

Question 9

Name the types of consent

Answer 9

• written consent (ideal)
• verbal consent
• implied consent
• important to document what was discussed

Question 10

List the five times information is NOT held confidential between a client and a psychologist

Answer 10

• incompetence
• therapeutic privilege
• waiver
• risk
• legal obligation

Question 11

Describe incompetence (re disclosure)

Answer 11

If the patient is unable to give valid consent, if they are a minor, if they are intellectually disabled, or they have dementia

Question 12

Describe therapeutic privilege (re disclosure)

Answer 12

Disclosure of information might have a detrimental effect on the patient, so need to discuss with patients the appropriate access to records and record format

Question 13

Describe ‘waiver’ (re disclosure)

Answer 13

A waiver means that the patient gives consent for their information to be shared. The psychologist needs to consider if the patient is capable of providing this consent

Question 14

Describe risk (re disclosure)

Answer 14

Psychologists are legally obliged to disclose the risks of self and others. They also need to consider their own safety and need to break consent if they feel unsafe - it’s their legal right

Question 15

What is meant by legal obligation (re disclosure)

Answer 15

Sometimes psychologists will be obliged to appear in court (eg subpoena) and will be legally required to disclosure certain information unless it is particularly harmful to the client

Question 16

What are four steps to facilitating and ensuring informed consent?

Answer 16

1. Clinical judgment of capacity
2. Written, documented consent
3. Checking patients understanding throughout the therapeutic relationship
4. View consent as an ongoing process

Question 17

List the risks of therapy

Answer 17

• breach of confidentiality
• risk of discomfort and distress
• risk of treatment failure
• risk of change
• risk of no change

Question 18

What are some examples of therapeutic risk?

Answer 18

Behaviour therapy:

• potential consequences of assertiveness
• exposure
• exposure and response prevention
• in Vivo exposure
• imaginal exposure

Question 19

How do we know that someone is competent to give consent?

Answer 19

• there is evidence of a choice
• they have the ability to understand relevant information, such as the nature and consequences of treatment, risks, benefits, and alternatives
• they understand the information
• evidence of a rational choice
• arrive at reasonable choice outcome

Question 20

Who typically has the capacity to give informed consent?

Answer 20

Those over 18. Under 14s need parental consent and same with under 18.

Question 21

Under what circumstances can children give informed consent?

Answer 21

If the child is judged as competent to give consent and demonstrate sufficient understanding, intelligence and maturity to understand fully what is proposed

Question 22

Name some situations where a child could give consent without necessarily talking to parents

Answer 22

• abusive or drug addicted parents
• the child is distressed at the thought of involving parents
• teen pregnancy

Question 23

What is not a mental illness?

Answer 23

Refusal to express or engage in certain beliefs
Sexual preference, gender identity or orientation 
Sexual promiscuity
Intellectual disability 
Cultural/racial group
Use of drugs or alcohol 
Family conflict
Previously treated for mental illness

Question 24

Describe what the Mental Health Act (2014) (Vic) says

Answer 24

• 1st July 2014
• determines the care, treatment and protection of people in vic with mental illness
• least possible restrictive and intrusive
• interference with rights, privacy, dignity and self respect of people with mental illness must be kept to a minimum
• empowers compulsory patients to make their own decisions about treatment
• people seeking or receiving treatment can make complaints

Question 25

When is someone put into ‘involuntary status’ according to the Mental Health Act (1986)

Answer 25

• person appears to be mentally ill
• requires immediate treatment which can be obtained by admission to and detention in an approved mental health service
• for patients health and safety and public protection
• person has refused consent or is unable to give consent
• adequate treatment is not possible if less restrictive