7: Capacity and consent Flashcards Preview

Psychiatry Week 3 2018/19 > 7: Capacity and consent > Flashcards

Flashcards in 7: Capacity and consent Deck (25)
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1

What does a patient need to be able to do to give their consent for an intervention?

Understand the intervention

Understand its pros and cons

Communicate their decision

Be able to retain the information

2

What stops a patient from being able to give informed consent for an intervention?

Lack of information

Cognitive impairment - inability to understand, weight up or retain information

Communication problems

Coercion

3

Does capacity for one decision apply to all other decisions a patient could make?

No

Assess capacity on a decision-by-decision basis

4

Who is an adult according to the

a) Adults with Incapacity Act

b) Mental Health Act?

a) 16+

b) 18+

5

What is the Adults with Incapacity Act FOR?

Treating physical illness in adults with mental disorders AND/OR inability to communicate

6

Can capacity be regained?

Yes

In acute, transient mental disorders like delirium

7

What does a patient need to know and repeat back to you to qualify as being informed about a decision?

What the intervention is, how it works and why it is being proposed

Benefits/risks

Consequences of not getting it

8

A patient should be assumed to (have capacity / not have capacity) until proven otherwise.

have capacity

9

What allows you to deal with medical emergencies regardless of the patient's capacity (unless there's an advance directive, DNR etc)?

Common law

10

What five principles must you keep in mind when using the Adults with Incapacity Act?

1. Intervention must benefit the patient

2. Benefit must not be achievable without the intervention

3. Patient's wishes (past & present) must be considered

4. Other relevant people (e.g family) should be consulted

5. Patient should be encouraged to use what's left of their capacity

11

If someone without capacity needs to receive an intervention, who should be consulted?

Patient (ask them anyway, they might have residual capactiy)

Decision-making proxies (power of attorney guardianship)

12

What decision-making proxy is appointed for patients who haven't arranged someone to have power of attorney over them?

Guardianship

long process, bit of a headache

13

What is a Section 47 certificate?

Form you can fill out to authorise treatment in an incapable patient with no power of attorney or guardian

14

What should you do if you speak to a patient and, in your opinion, they don't have capacity to consent to a treatment?

Document that

then fill out a section 47 form (assuming they have no decision-making proxies)

15

The AWIA allows you to treat (physical / mental) disorders in which two groups of patients?

physical disorders

in those with MENTAL DISORDERS or INABILITY TO COMMUNICATE

16

The MHA allows you to treat (physical / mental) disorders.

mental disorders

As opposed to AWIA, which is for physical disorders in patients with mental disorders or inability to communicate

17

What is covert medication?

Medication administered without the patient's knowledge e.g tablets ground into food

18

Are you allowed to give covert medication to a patient?

Yes

If you can justify it under AWIA

19

Which detention form can be filled out by any FY2+ doctor with the consent of a Mental Health Officer?

Emergency detention

20

How long does an emergency detention last?

Can it be appealed?

72h

No appeal

21

How long does a short term detention order last?

Who authorises it?

Can it be appealed?

28 days

ST6+ psychiatrist + MHO

Yes

22

How long does a compulsory treatment order last?

Who authorises it?

6 months

Tribunal

23

Can you treat illness under an emergency detention order?

No

Requires a short term detention order

24

What is an advance statement under the MHA?

Document written by the patient stating that they would want to be admitted and treated if they became unwell

25

Emergency detention is advised under what circumstances?

Patient is mentally ill and needs to be assessed

They pose a risk to themselves or others

There's no time to file for a short term detention

mind they can't be treated