Week 10: Informed consent Flashcards
Describe informed consent
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.
What is meant by ‘informed’
Disclosure of appropriate information, including the the treatment, what is involved, risks and benefits, and alternative options
What is meant by ‘consent’
- 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
Why is informed consent important for client rights?
- it is the right of clients to be informed
- gives them autonomy/self determination
- they have the right to refuse treatment
What other principles are involved in informed consent?
- justice (equal treatment)
- non maleficence/beneficence (do no harm)
Why is informed consent important for collaboration?
- participant needs to be involved, educated and willing to participate in therapy
- we respect our clients as decision makers
Discuss full disclosure
- can be virtually impossible
- adequate disclosure is determined by the professional community
- doctor knows best is a problematic approach to take
What is the reasonable person rule?
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
Name the types of consent
- written consent (ideal)
- verbal consent
- implied consent
- important to document what was discussed
List the five times information is NOT held confidential between a client and a psychologist
- incompetence
- therapeutic privilege
- waiver
- risk
- legal obligation
Describe incompetence (re disclosure)
If the patient is unable to give valid consent, if they are a minor, if they are intellectually disabled, or they have dementia
Describe therapeutic privilege (re disclosure)
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
Describe ‘waiver’ (re disclosure)
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
Describe risk (re disclosure)
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
What is meant by legal obligation (re disclosure)
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
What are four steps to facilitating and ensuring informed consent?
- Clinical judgment of capacity
- Written, documented consent
- Checking patients understanding throughout the therapeutic relationship
- View consent as an ongoing process
List the risks of therapy
- breach of confidentiality
- risk of discomfort and distress
- risk of treatment failure
- risk of change
- risk of no change
What are some examples of therapeutic risk?
Behaviour therapy:
- potential consequences of assertiveness
- exposure
- exposure and response prevention
- in Vivo exposure
- imaginal exposure
How do we know that someone is competent to give consent?
- 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
Who typically has the capacity to give informed consent?
Those over 18. Under 14s need parental consent and same with under 18.
Under what circumstances can children give informed consent?
If the child is judged as competent to give consent and demonstrate sufficient understanding, intelligence and maturity to understand fully what is proposed
Name some situations where a child could give consent without necessarily talking to parents
- abusive or drug addicted parents
- the child is distressed at the thought of involving parents
- teen pregnancy
What is not a mental illness?
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
Describe what the Mental Health Act (2014) (Vic) says
- 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
