Capacity and Consent

Question 1

Define consent?

Answer 1

Permission for something to happen or an agreement to do something

Give permission for something to happen

Question 2

Define capacity?

Answer 2

Ability to make a decision

Question 3

What is required for someone to have capacity?

Answer 3

1. Understand and retain relevant info:
   • What the intervention is, its nature and purpose and why it is proposed
   • Main benefits / risk / alternatives
   • Consequences of not receiving the intervention
2. Use and weight that info to make a decision
3. Communicate that decision

Question 4

Important facts about capacity?

Answer 4

A person may have capacity for one decision but not for another

CAPACITY SHOULD BE ASSUMED UNTIL PROVEN OTHERWISE

In a medical emergency, deal with the situation and then deal with the legal paperwork

Question 5

Principle of the Scottish Adult With Incapacity (AWI) act?

Answer 5

1. Intervention must benefit the adult
2. Such benefit cannot reasonably be achieved without intervention
3. Take account of past and present wishes
4. Consult with other relevant persons
5. Encourage adult to use residual capacity

NOTE - this is different from England

Question 6

What is power of attorney?

Answer 6

Allocated by the individual to a chosen person so that they can make financial, welfare and property decisions should the person themselves be unable to

Valid until person revokes it

Question 7

What is guardianship?

Answer 7

Granted by a court, to allow a person to be able to make financial, welfare and property decisions for another person who is unable to

This has a time limit and needs to be renewed

Question 8

What is used to authorise treatment of a physical disorder in a patient without capacity to consent?

Answer 8

AWI section 47, which includes:
• Your details
• Patient details
• Treatment you want to authorise
• Nature of incapacity and how long you expect it to continue
• Sign and date it

Question 9

Purpose of the Mental Health (Care and Treatment) (Scotland) Act?

Answer 9

Allow for treatment of a mental disorder or physical consequences of that mental disorder in someone without capacity to consent

NOTE - this is different from England

If a patient is actively resisting treatment for a mental disorder, MHA should be used rather than AWI, as it affords them more protection

Question 10

Principles of MHA (Scotland)?

Answer 10

1. Emergency detention certificate
2. Short term detection certificate
3. Compulsory treatment order
4. Advance statement
5. Nurses’ holding power

Question 11

Criteria that must be met for emergency detention?

Answer 11

1. LIKELY to have a mental disorder
2. Significantly impaired decision-making ability regarding treatment, due to the mental disorder
3. Detention in hospital is necessary as a matter of urgency to determine what treatment is required
4. Risk to health, safety or welfare of the person, or to the safety of other
5. Making arrangements for a short-term detention certificate would inv. undesirable delay

Question 12

Criteria that must be met for a short-term detection certificate?

Answer 12

1. LIKELY to have a mental disorder
2. Significantly impaired decision-making ability regarding treatment, due to mental disorder
3. Detention in hospital is necessary for assessment or treatment
4. Risk to health, safety or welfare of the person, or to the safety of others
5. Cannot be treated voluntarily

Question 13

Age of legal capacity in Scotland?

Answer 13

Assume capacity if >16 years old

Patient under the age of 16 can consent to medical treatment on their own behalf, if they have capacity to do so in the opinion of a qualified medical practitioner