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Medical Ethics & Law > Legal Aspects of Consent > Flashcards

Legal Aspects of Consent Flashcards

1
Q

Consent to treatment means what?

A

Consent to treatment means person must give permission before they receive any type of treatment, test or examination:

  • Clinician must explain what it is
  • Consent from patient is needed regardless of procedure
  • Principle of consent is important part of medical ethics and international human rights law
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2
Q

What are different kinds of consent?

A
  • Implied or verbal agreement for non-invasive treatments
  • Express consent for minor or routine investigations
  • Written consent for procedures that involve higher risk such as surgery
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3
Q

What kind of consent is needed for non-invasive treatments?

A

Implied consent

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4
Q

What kind of consent is needed for minor or routine investigations?

A

Express consent

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5
Q

What kind of consent is needed for procedures that involved higher risk such as surgery?

A

Written consent

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6
Q

Examinations of intimate zones with lack of adequate consent can lead to what?

A

Accusations of indecent assualt

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7
Q

Examations or treatment without adequate consent can lead to what?

A

Accusations of common assualt

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8
Q

All intimate examinations require what?

A

A chaperone

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9
Q

Any consent must be informed consent, what does this mean?

A
  • Meaning patient should be informed of practicalities of procedures, the benefits and risks involved and if they refuse
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10
Q

Describe how consent is obtained?

A
  • Listen to patient and respect views
  • Discuss diagnosis, prognosis and treatment
  • Share with patients information they want or need to make decisions
  • Maximise patients opportunities and ability to make decisions (autonomy)
  • Respect patients decisions
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11
Q

Can doctors pressure patients to choose what they believe to be their best option?

A

Doctor must recommend option they believe to be best for patient, but must not pressure patient to accept (no coercion)

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12
Q

Does a doctor have to provide treatment that the patient requests?

A

If patient asks for treatment doctor believes to not be beneficial the doctor does not have to provide, but must explain their reasons to the patient

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13
Q

All decisions should be recorded where?

A

In medical records or on consent form

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14
Q

Why should you check if patients wish to go ahead with treatment even if they have previously consented?

A
  • May have changed mind
  • May have been material change in patients condition
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15
Q

Consent depends on what?

A

Consent depends on capacity:

  • Only patients with capacity can consent
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16
Q

What are things that can impact capacity?

A
  • Pain
  • Impaired intellectual capacity
  • Unconscious
  • Communication difficulties
  • Age
  • Fear
  • Confusion
  • Effects of medication, drugs or alcohol
17
Q

What are some methods to get around communication difficulties that inpact capacity and ability to consent?

A
  • Next of kin
  • Braille information leaflets/consent form
  • Sign language
  • Interpreter via phone or in person
18
Q

How old do you have to be to have capacity to consent?

A
  • In England and Wales child is someone who has not reached 18
  • In Scotland, definition varies but in most situations is someone under 18, in some situations such as in children’s hearings and child protection orders a child is a person under 16
19
Q

In Scotland, when can patients under 18 consent?

A
  • Under 16 can consent if believed to have enough intelligence and understanding (Gillick competent)
  • People aged 16 or 17 are presumed to have enough capacity to make their own decisions unless significant evidence suggests otherwise
20
Q

When can consent be overruled in a young person in Scotland?

A
  • If they refuse treatment which may lead to death or severe permanent injury can be overruled by Court of Protection
  • Parents, but usually thought best to go through courts
21
Q

What is capacity?

A

Can understand, believe, retain and weight the necessary information

22
Q

Capacity is governed by what legislation in England and Wales, and in Scotland?

A

England & Wales - Mental Capacity Act 2005

Scotland - Adults with Incapacity Act 2000

23
Q

In law, “incapable” means what?

A
  • Incapable of
    • Acting on decisions or
    • Making decisions or
      • Communicating decisions or
      • Understanding decisions or
      • Retaining the memory of decisions
    • In relation to any particular matter due to mental disorder or inability to communicate because of physical disability
24
Q

What are the principles of the Adults with Incapacity Act 2000?

A
  • Principle 1
    • Any action or decision taken must benefit person
  • Principle 2
    • Least restrictive option
  • Principle 3
    • Take account the wishes of person
  • Principle 4
    • Consultation with relevant others
  • Principle 5
    • Encourage the person to use existing skills and develop new skills
25
Q

Does the AWIA allow a person to make all decisions for an incapacitated person?

A

No, decisions such as consent to marriage or a will can never be made, other restrictions

  • Welfare attorney cannot place person they are acting for in a mental hospital against their wishes or consent to certain treatments
26
Q

What conditions are required for consent to be valid?

A
  • Must be voluntary and informed
  • Must have capacity
27
Q

What does “voluntary” mean in law?

A

The decision to either consent or not must be made by person and not influenced by pressure from anyone

28
Q

What does “informed” mean in law?

A

Person must be given all the information about treatment including benefits and risks, alternative treatments and what will happen if treatment does not go ahead

29
Q

What does “capacity” mean in law?

A

Understand, retain and believe the information given to them and use it to make informed decision

30
Q

What is power of attorney?

A
  • Whilst individuals have capacity can grant someone powers to act on their behalf for financial or welfare attorney
31
Q

What are the different kinds of power of attorney?

A

Financial attorney

Welfare attorney

32
Q

When does financial and welfare power of attorney come into effect?

A
  • Financial power of attorney comes into effect when specified, welfare only when the granter loses capacity
33
Q

All powers of attorney must be registered with who?

A

Pubic guardian

34
Q

How can treatment be given to someone with no capacity if they have not previously appointed power of attorney?

A
  • If person hasn’t appointed power of attorney and has no capacity to make decision then healthcare professionals can administer treatment if they believe it is in the patient interest
    • Clinicians must discuss with patients family/friends
    • If agreement cannot be reached the case may be taken to court

Medical Ethics & Law (14 decks)

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