Week 11 / Consent and Capacity

Question 1

Flashcard 1
Q: How does the Oxford English Dictionary define “to consent”?

Flashcard 2
Q: Why is obtaining consent important in healthcare?

Flashcard 3
Q: Why is consent essential in pharmacy practice?

Flashcard 4
Q: What professional and legal duty do pharmacy professionals have regarding consent?

Flashcard 5
Q: What must pharmacy professionals know and comply with in relation to consent?

Answer 1

A: “To express willingness, give permission, agree.”

A: Because people have a basic right to be involved in decisions about their healthcare.

A: It helps form and maintain effective partnerships between pharmacy professionals and people receiving care.

A: They must obtain a person’s consent for professional services, treatment or care, and for using the person’s information.

A: The law and good practice requirements that apply to them in their daily practice.

Question 2

Q: What are the two types of consent in pharmacy practice?

Answer 2

A: Explicit (or express) consent and implied consent.

Question 3

Q: What is explicit (or express) consent?

Answer 3

A: When a person gives specific permission, either spoken or written, to do something.

Question 4

Q: What is implied consent?

Answer 4

A: When a person gives consent indirectly, such as handing in a prescription to be dispensed.

Question 5

Q: When is implied consent valid?

Answer 5

A: Only if the person understands what they are consenting to.

Question 6

Q: What should a pharmacy professional do if they are unsure about implied consent?

Answer 6

A: Seek explicit consent.

Question 7

Q: What must pharmacy professionals use to decide what type of consent to obtain?

Answer 7

A: Their professional judgement.

Question 8

Q: What should pharmacy professionals consider when deciding on the type of consent needed?

Answer 8

A: Legal requirements, NHS service requirements, and workplace policies.

Question 9

Q: What is meant by “informed consent”?

Answer 9

A: When a person has enough balanced information, including any material risks, to make an informed decision.

Question 9

Q: What are the four key criteria for consent to be valid?

Answer 9

A: The person must:

Have capacity to give consent

Be acting voluntarily

Have sufficient balanced information to make an informed decision

Be capable of using and weighing up the information provided

Question 10

Q: Why is understanding the consequences of not giving consent important?

Answer 10

A: It ensures the person fully comprehends their options and the potential outcomes of refusing treatment or care.

Question 11

Q: What must the information provided include to help a person give informed consent?

Answer 11

A: It must include any material risks involved in the recommended treatment or care.

Question 12

What is the bolam principle?

Answer 12

a doctor is not negligent if he acts in
accordance with a practice accepted at the time as proper by a responsible body of medical opinion

Question 13

Montgomery v Lanarkshire Health Board (Scotland) 2015

Answer 13

OPEN PP

Question 14

what is the bolam principle a test of ?

Answer 14

Bolam Principle is a test to see if a practitioner has met their duty of care

Question 15

What is the Montgomery Principle

Answer 15

A healthcare professional has a duty of care to take reasonable steps to ensure that the patient is aware of any material risks involved in any recommended treatment, and of any reasonable alternative or variant treatment

Question 15

Q: What kind of relationship should exist between a healthcare professional and a patient when gaining consent?

Answer 15

A: A relationship based on openness, mutual trust, and good communication skills.

Question 16

Q: What are key actions a healthcare professional must take to work in partnership with the patient during the informed consent process?

Answer 16

A:

Listen to the patient

Respect the patient’s views

Discuss diagnosis, prognosis, and care plan

Share all relevant clinical information

Maximise opportunities for decision-making

Respect the patient’s decision

Question 17

Q: What is the basic process of gaining informed consent from a patient with mental capacity?

Answer 17

A:

Ensure the patient understands the nature of the process and their role in it

Provide the patient with all relevant information

Establish a shared understanding of clinical expectations and limitations

Question 18

Q: What law defines mental capacity in England and Wales?

Answer 18

A: The Mental Capacity Act 2005.

Question 19

Q: According to the Mental Capacity Act 2005, when is a person considered to lack capacity?

Answer 19

A: When, at the time a decision needs to be made, they are unable to make or communicate the decision due to an impairment or disturbance in the functioning of the mind or brain.

Question 20

Q: Are there degrees of capacity?

Answer 20

A: No, a person either has capacity to make a particular decision or does not.

Question 21

Q: Can a person have capacity for some decisions and not others?

Answer 21

A: Yes, capacity is decision-specific; a person may be able to make some decisions and not others.

Question 22

Q: What is the assumption about children under 16 and capacity?

Answer 22

A: They are assumed not to have capacity unless they demonstrate sufficient understanding and intelligence to fully understand what is proposed.

Question 23

Q: At what age is capacity assumed unless proven otherwise?

Answer 23

A: Age 16 and over.

Question 24

Q: What key factors should be considered when assessing a person’s capacity?

Answer 24

A: Is the incapacity permanent or temporary? What option benefits the patient most? What is the least restrictive option? Is there advanced planning documentation? Who holds legal power of attorney? What are the family's and healthcare team’s views?

Question 25

Q: What are the four criteria used to assess if a patient lacks capacity?

Answer 25

A: The patient is unable to: Understand the information Retain the information Use and weigh up the information Communicate a decision (by any means)

Question 25

Q: Should a person’s lack of capacity for one decision be assumed for all decisions?

Answer 25

A: No. Capacity is decision-specific and may vary with time and situation.

Question 25

Q: What should pharmacy professionals do to support a person in making decisions?

Answer 25

A: Time discussions to suit the person's best level of understanding Use simple language or visual aids Involve others in communication (e.g. family member, interpreter)

Question 26

Q: Who can be consulted if there is doubt over a patient’s capacity?

Answer 26

A: Clinical team Nursing staff Other healthcare professionals or specialists Legal services or solicitors

Question 27

Q: Who typically provides informed consent for patients under 16?

Answer 27

A: Parents or legal guardians.

Question 28

Q: What did the ruling in W vs. W determine?

Answer 28

A: A parent can give informed consent for a minor if it is something a “reasonable parent” would consent to.

Question 29

Q: What was the outcome of the case Gillick v. West Norfolk and Wisbech AHA (1986)?

Answer 29

A: The House of Lords ruled that children under 16 can give valid consent to medical treatment in certain circumstances, without parental permission.

Question 30

Q: What are the Fraser Guidelines used for?

Answer 30

A: To determine when a healthcare professional can give treatment (e.g., contraception) to a child under 16 without parental knowledge or consent.

Question 31

Q: What are the five criteria of the Fraser Guidelines?

Answer 31

A: The young person cannot be persuaded to involve their parents. The young person understands the advice or treatment. Without treatment, their physical or mental health is likely to suffer. It is in their best interest to receive the treatment/advice. The young person is likely to continue engaging in sexual activity with or without the treatment.

Question 32

Flashcard 1 Q: When does parental responsibility for consent to medical treatment end for a child? Flashcard 2 Q: Do both parents have the right to give consent if they are both named on the birth certificate? Flashcard 3 Q: How does parental responsibility work for children conceived by IVF? Flashcard 4 Q: How does parental responsibility apply for a minor subject to a care order? Flashcard 5 Q: When does parental responsibility legally end in cases of adoption? Flashcard 6 Q: In certain situations, who can consent to clinical treatment for minor ailments in school?

Answer 32

A: Parental responsibility continues until the child reaches the age of 18. A: Yes, both parents have the right, regardless of marital status. A: Parental responsibility for IVF-conceived children is decided on a case-by-case basis. A: The local authority shares parental responsibility with the parents. A: Parental responsibility ends when a minor is adopted. A: A school may have the right to consent.

Question 33

Flashcard 1 Q: When can treatment be provided in an emergency without consent? Flashcard 2 Q: What should be considered before providing treatment in an emergency situation? Flashcard 3 Q: What is the key condition for providing emergency treatment without consent?

Answer 33

A: Treatment can be provided if it is in the person’s best interests, needed to save their life, or to prevent deterioration in their condition. A: It’s important to consider if an advanced directive exists where the patient may have previously declined the treatment. A: The treatment must be necessary to save the person's life or prevent their condition from worsening.