Consent and Capacity

Question 1

What is the criteria for someone with capacity

Answer 1

to act (to give consent)
to make reasoned decisions 
to communicate decisions
to understand decisions 
to retain the memory of decisions

Question 2

What is meant when we say that to have capacity someone has to have a reasoned decision

Answer 2

there is reason behind their decision - it is not impulsive nor random
we may not agree with their reasons but it is their decision

Question 3

What is meant when we say to have capacity someone has to communicate their decision

Answer 3

they must be able to express their decision

arrangements may need to be made so they can e.g in language barriers

Question 4

What is meant when we say to have capacity someone must be able to understand their decision

Answer 4

that they have proper understanding of what they are doing
they are understand the consequences
require SUFFICIENT UNDERSTANDING

Question 5

What is meant when we say to have capacity someone must be able to retain the memory of decisions

Answer 5

They must be able to remember for long enough

Question 6

What is the criteria for consent

Answer 6

valid
with capacity
informed
voluntary (not coerced nor manipulated)

Question 7

What is the criteria for consent to be VALID

Answer 7

the consent must be IN DATE

the consent must be SPECIFIC to the TX PLAN

Question 8

What do we mean when we say that a criteria for consent is that it is done with capacity

Answer 8

that they meet the criteria of capacity

Question 9

What do we mean when we say that a criteria for consent is that the patient must be properly informed

Answer 9

they need to know what the treatment is all about
they require proper information before consenting
should they not have proper info then the consent is not valid

Question 10

What is the subcategories of voluntary consent

Answer 10

that it is not coerced nor manipulated

Question 11

What do we mean when we say that the consent is not coereced

Answer 11

consent should not be forced
you need to tell someone all their different options so that they are not lead down one path
common problem with private tx

Question 12

What do we mean when we say that the patient is not manipulated to consent

Answer 12

you cannot manipulate the patient so they choose what you want to choose

Question 13

What are the 3 aspects to risk communication

Answer 13

probability
severity
material risk

Question 14

What is probability

Answer 14

how likely is it that it will happen

Question 15

What is the severity

Answer 15

how bad the outcome could possibly be

Question 16

What is the material risk

Answer 16

risks that matter to the patient e.g missing work

Question 17

What standard relates to consent

Answer 17

standard 3 - obtain valid consent

Question 18

What are the two conditions for consent

Answer 18

valid and legal

Question 19

What should consent be perceived as

Answer 19

a continuing process

not a one off decision

Question 20

When should consent be renewed

Answer 20

when there has been a significant interval between the patient agreeing to a tx option and its start

Question 21

What does a patient who has capacity able to do

Answer 21

to give or to withhold consent

Question 22

What age is the presumption of capacity

Answer 22

16 YO

Question 23

When does parental responsibility end

Answer 23

age 16

Question 24

Who has parental responsibility

Answer 24

mum

dad if married or on birth certificate

Question 25

What aere things that patients might want to know

Answer 25

``` options for tx, risks and benefits why you think tx is necessary/appropriate consequences, risks and benefits of tx likely prognosis recommended option cost what can happen if tx doesn't happen whether tx is gauranteed, how long it is guaranteed for and any exclusions ```

Question 26

What are material risks

Answer 26

a reasonable person, if warned of the risks, would be likely to attach significance to these

Question 27

What is the mode of obtaining consent

Answer 27

it can be implied or explicit

Question 28

What is implied consent sufficient for

Answer 28

minor procedures

Question 29

What is explicit consent required for

Answer 29

major or invasive procedures

Question 30

What is written consent required for

Answer 30

GA | continuous sedation

Question 31

When is consent not required

Answer 31

when an emergency arises in a clinical setting and it is not possible to find out px wishes tx you provide must be the least restrictive of px future choices for as long as the px lacks capacity, you should provide ongoing care and if the patient regains capacity then explain what has been done and why

Question 32

Should parents be in disagreement, do you require both parents to consent

Answer 32

no - only 1

Question 33

Can parental responsibility be handed over?

Answer 33

no but is is possible for someone looking after child to act on behalf of person with parental responsibility when given EXPLICIT PERMISSION to do so

Question 34

What is informed consent

Answer 34

sufficient info must be communicated so that the patient can make an informed decision about whether or not to accept the proposed tx based on knowledge and understanding

Question 35

How is informed consent achieved

Answer 35

specific questions must be answered fully and honestly info given should be documented carefully tx should not exceed consent given patients individual needs and wishes should be checked

Question 36

What does the adults with incapacity act 2000 allow

Answer 36

it allows people to make their own choices about who will handle their affairs if they cannot do it themselves the act makes it simpler for carers to help with granters affairs

Question 37

What is granted by the office of public guardian if px who has formally nominated a person for this e.g spouse prior to losing capacity

Answer 37

POWER OF ATTORNEY

Question 38

What is welfare power of attorney

Answer 38

for the care and personal needs of the adults | healthcare, clothing, diet

Question 39

When is welfare power decided

Answer 39

by the adult while capable | only has effected while the adult lacks capacity

Question 40

What is continuing power of attorney

Answer 40

for finance and property

Question 41

What is an intervention order

Answer 41

when someone has no power of attorney and a one off decision needs to be made on behalf of the adult with incapacity

Question 42

What must use of the incapacity act be allied with

Answer 42

``` benefit of the adult minimum intervention present and past wishes of adult consultation with the adult and others the adult's exercising of their skills and further development of these ```

Question 43

Who should be consulted about any action according to incapacity act

Answer 43

``` adult next of kin carer appointed attorney guardian ```