Week 5 Flashcards
Informed Consent and the Health Care Consent Act (1996)
The nature of the treatment
The expected benefits of the treatment
The material risks of the treatment
The material side effects of the treatment
Alternatives courses of action
The likely consequences of not having the treatment
Free and Informed Consent
Patients have the right to refuse consent to be treated, even if treatment is in their best interest
Nurses are obligated to advocate for patients
who are not fully informed
who require more time to reflect on alternatives
when their wishes have not been respected
Lack of Consent (Battery)
In health care settings, any treatment, surgery, nursing action, diagnostic test, or intervention that occurs without prior consent is forbidden unless the patient is unable to consent and delay could result in serious bodily harm or death.
Conditions of Informed Consent
For consent to be valid, it must be given voluntarily without coercion or undue pressure.
Consent must be fully informed regarding the risks and benefits of treatment, as well as the risks of foregoing treatment.
Consent muse be specific, regarding the proposed treatment or procedure and who will perform the treatment or procedure.
Consent must be given by a legally capable person.
Two types of consent
Expressed consent is a clear statement of consent given by the patient. It is often a written consent.
Implied consent is inferred from the patient’s conduct (e.g., holding out his or her arm for an injection).
In Ontario, legislation related to consent is found in the
Health Care Consent Act (1996) and the Substitute Decisions Act (1992).
Ontario’s Substitute Decisions Act (1992)
Under this Act, the two methods of providing a substitute decision maker for an incapable person are: The appointment (in advance of becoming incapable) of a power of attorney for personal care An application to the court for the appointment of a guardian
Duties of Guardians and Attorneys for Personal Care
Both guardians and attorneys for personal care are required to exercise their powers diligently.
They are required to try to determine the incapable person’s prior wishes and values.
They must make decisions that are in the person’s best interests.
They must consult with the person’s family, friends, and health care professional whenever possible
Case Law on Consent Reibl v. Hugues (1980)
the plaintiff suffered from a blocked left carotid artery. He was booked for an elective internal carotid endarterectomy, which was performed by the defendant, a neurosurgeon.
During the surgery, or immediately after, the plaintiff suffered a stroke, which resulted in unilateral paralysis, impotence, and permanent disability. The plaintiff sued the neurosurgeon for the surgeon’s failure to inform him adequately of the risks of the surgery.
The case reached the Supreme Court of Canada, where the surgeon was held liable for not explaining the risks adequately.
Case Law on Consent Malette v. Shulman (1990)
The plaintiff had been seriously injured in a motor vehicle accident and rushed to a nearby hospital. She had sustained serious injuries to her head and face and was bleeding profusely.
The physician on duty in the Emergency department determined that she would need blood transfusions to maintain her blood volume. A surgeon made the same determination and she was barely conscious at the time. She had a card printed in French and signed by the patient identifying her as Jehovah’s Witness with clear refusal of blood transfusion.
The Court found that informed consent was required and upheld the finding of liability for battery against the physician.
metabolism
- The biochemical reactions occurring within a cell or organism
- How a cell obtains, stores and uses energy
exergonic rxns occur when
molecules are digested
endergonic rxns occur when
molecules are synnthesized
coupled rxn
- When endergonic and exergonic reactions are paired
* The energy released by the exergonic reaction is used in the endergonic reaction
