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Flashcards in Consent and the Incompetent Adult Deck (7)
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What types of patients could be deemed incompetent?

- Children
- People with dementia
- People with a mental illness or cognitive impairment
- People affected by alcohol or drugs
- Unconscious people


Which three acts govern the treatment of incompetent adults?

1) Guardianship and Administration Act 2000 (Qld)
2) Powers of Attorney Act 1998 (Qld)
3) Mental Health Act 2000 (Qld)


When a patient is deemed incompetent, what is the order of people who can make a decision on behalf of the patient?

1) AHD (if the patient has one)
2) Appointed Guardian by the Guardianship and Administration Tribunal
3) Enduring Power of Attorney
4) Statutory Health Attorney
- Spouse of adult if close and continuing
- Adult non-paid carer
- Adult close friend or relation and not paid carer
If a patient does not have any of the above, the doctor can apply to the Guardianship and Administration Tribunal to have a guardian appointed.


The health provider must inform the substitute decision maker so that they can make an informed decision. What details must be disclosed?

The details would include what is normally required for a competent adult (cover the person, procedure, no coercion, check for understanding, competence), as well as explaining the patient's condition at the time, type of health care required, rationale, alternatives and risks.


What are details which can be included in an AHD?

An AHD can give directions on future health matters for his/her future health care.
- This includes consent, in the circumstances specified, to the future health care of the principle when necessary.
- The withholding or withdrawing of life sustaining measures.
- Authorising an attorney to physically restrain, move or rearrange the principal, where necessary, for the purpose of healthcare, even despite objection by the principal at the time.
The direction in an AHD has priority over that of any attorney.
An AHD is not revoked by the principal becoming a person with impaired capacity.


What is an AHD?

An AHD is a document that sets out the wishes of a patient in certain medical situations.
It must be signed and witnessed to have effected. It must also include a certificate signed and dated by a doctor stating that the principal, at the time of making an AHD appeared to have the capacity necessary.


What are two concerns surrounding AHDs?

1) Currency of the document - whether the AHD still reflects what the principal currently desires. It is recommended that AHDs are reviewed every 5 years.
2) Specificity. It must accurately detail what the patient is prepared to allow or not allow in teats of treatment.