Informed Consent Flashcards
what are the elements of consent
sufficient information for the general nature of the procedure which should be given to the patient
voluntary: freely given, not obtained by fraud, not given under duress
what is informed consent
considered decision of a person to accept or reject an intervention offered
based on an understanding of information given by experts in a field
requires consideration of acceptance or rejection of the intervention
what can’t a patient do
insist on a particular intervention, the clinical decision is based on expertise
what are the two essentials of an autonomous person
liberty: independence form controlling influences
agency: capacity for intentional action
what is the reasons for a person to have diminished autonomy
controlled by others
incapable of deliberating
incapable of acting on the bases of his/her own wishes
what is section 5 of the MCA
where a person is providing care or trt for someone who lacks capacity, then the person can provide the care without incurring legal liability
what is section 6 of the MCA
allows restraint to be used if one reasonably believes it is necessary to prevent harm to the incapacitated person
what patients tend to lack capacity
- if very unwell
- altered levels of consciousness
- malignancy affecting the brain: advanced or met
how do you assess capacity
starting point is to assume they have capacity to make a specific decision
proof is needed if it is claimed that they lack capacity
what are the 5 principles of the MCA
person is assumed that they have capacity unless it is established
not treated as unable to make a decision unless all practicable steps to help them to do so have been taken without success
not treated as unable to make a decision merely because they make an unwise decision
an act done under this act for or on behalf of a person is completed in their best interests
regard must be had to whether the purpose for which it is needed can be as effectively achieved in a way that is less restrictive of the persons rights and freedom of action
power of attorney
- someone you trust is in charge of your affairs
- must be over 18 years old
what is a lasting power of attorney
18 or older and have mental ability to make financial, property and medical decisions for yourself, you can arrange someone to make these decisions in the future
knowledge and understanding
consider emotional impact
consider level of capacity
discuss trt outcome
discuss alternatives
patients knowledge of the disease process
patients knowledge of trt intention
palliative nature of trt, aim of it
what can be reasonably achieved
timescale, how long will it take to work and how long will it last
timescale
does the patient have time to accept or decline
informed consent in palliative care
adapt information given
patient general condition
ensure pain relief is given before consultation
sensitivity in explaining expectations: false hopes, realistic time frames of effects, don’t rush the patient
