Consent Flashcards
What is consent?
Patient’s voluntary agreement to treatment, examination or other aspects of health care
What are the main legal points to consider?
CIVIL LAW
- battery (rare)
- negligence (rare-ish)
CRIMINAL LAW
- assault/battery (v. rare)
What is valid consent?
- voluntariness
- competence
- information
consent should be CONTINUING - patients should know they can change their mind
What is competence?
ability to:
- understand relevant information
- retain relevant information
- weigh up relevant information
- communicate decisions
task-specific and can fluctuate (confusion, panic, shock & fatigue)
How should information be given for valid consent?
Procedure
Alternative
Risk
Question
What are the 3 models which address how much info is adequate?
- Professional practice standard
- Reasonable/prudent person standard
- Subjective standard
What is considered as ‘not negligent’ for the doctor?
- acted in accordance with a practice accepted as proper
- be deemed ok by the judgement of a reasonable patient
- Explain any risks to which they [patients] may attach particular significance
How did the Montgomery trial change how consent is handled?
BEFORE: Bolam’s test and Sidway judged as reasonable by a fellow medical professional
AFTER: must inform on material risks involved in Rx. Material = risk that a reasonable person may attach significance to
What does voluntariness mean?
Patients must be able to refuse
Patients must know that they are able to refuse
Patients must be free from undue pressure (i.e. free from coercion and perceived coercion)
What are the other challenges in obtaining consent?
Scope of Consent: consent is specific
Delegating Consent:
Can be done but stick to rules
Signed Consent Forms:
Provides minimal evidence that decision making process was adequate
What are the limitations of informed consent?
not possible or necessary when pt:
- is not competent to make decision
- poses serious risk to others if not treated or restrained (complex)
- declines “all” information
What obstruct a patient from giving informed consent?
Presentation of information
Complexity of information/clinical uncertainty
Effects of fear, illness, social status of doctor, embarrassment, clinical environment, on decisions
Time consuming
Presentation of information
Complexity of information/clinical uncertainty
Effects of fear, illness, social status of doctor, embarrassment, clinical environment, on decisions
Time consuming
