In paragraph 5, which relates to the applications for patients without capacity, it says:. There are other procedures or treatments not contained in the list which can be regarded as serious medical treatment see link to Practice Direction in the Further Reading section below. Whether or not a procedure is regarded as serious medical treatment will depend on the circumstances and the consequences for the patient. There are very few occasions where the law specifically requires written consent — for example, in relation to the storage and use of gametes and embryos in fertility treatment.
But in the main, a verbal consent is just as valid as written consent. Consent is a process — it results from open dialogue, not from getting a signature on a form.
Completed consent forms provide some evidence that consent was obtained, but mean little beyond that — it is important to realise that they do not constitute proof that the consent was valid. If there is any dispute over whether valid consent was obtained, the key issue will not be whether the patient signed a form or not, but whether they were given all the information they needed to make a considered decision.
It is, therefore, crucial that the essential elements of discussions with the patient are documented in the medical record. The notes do not need to be exhaustive, but should state the nature of the proposed procedure or treatment and itemise the risks, benefits and alternatives brought to the attention of the patient.
Any particular fears or concerns raised by the patient should also be noted. A significant proportion of clinical negligence claims are settled simply because valid consent was not obtained.
In theory, where harm has befallen the patient and consent was not obtained, this could also give rise to claims for assault or battery and, in extreme cases, criminal charges, but fortunately this is exceptionally rare. You'll notice a few things have changed on our website. After asking our members what they want in an online platform, we've made it easier to access our membership benefits and created a more personalised user experience.
Your patient does not give consent for the examinations. Think about it As the emergency physician, what is the best next step? Suggestions In this case, the physician should explain the grave risks if a condom containing cocaine ruptures internally. The patient might then consent to examination. In these types of circumstances, physicians should be more careful than usual to assure themselves the patient is in full agreement with what has been suggested, that there has been no coercion for example, by exaggerating the risks of consenting or of refusing and that no one else has imposed their will on the patient.
Case: A year-old man scheduled for colonoscopy Background A gastroenterologist meets a patient for the first time immediately before a screening colonoscopy. He describes the list of potential risks for colonoscopy and requests the patient sign the consent form before proceeding.
Think about it Is the patient consenting voluntarily? Suggestions Ideally the patient would be provided information about the nature and risks of an investigation as early as possible in the process. In this case, the patient has already made the decision to undergo the procedure and has completed the required preparation. Despite this, the patient is entitled to engage in a full discussion and should not be made to feel obliged to continue with the investigation.
Capacity to consent A patient is considered to have the capacity to consent if he or she understands the: nature of the proposed investigation or treatment anticipated effect of the proposed treatment and alternatives consequences of refusing treatment. Patient understanding Take reasonable steps to be satisfied the patient comprehends the consent discussion. Physicians have a duty to take reasonable steps to be relatively satisfied their patients have received the appropriate information, particularly when there may be language difficulties, emotional issues, or questions of mental function.
By engaging in dialogue with the patient, a physician will be reasonably confident that the patient appears to understand the explanation of consent.
One way to achieve such confidence is the teach-back technique: asking the patient to re-phrase what they have just been told and inviting the patient to ask questions. However, what constitutes "reasonable steps" will depend on the facts and circumstances of the particular situation.
As appropriate, a physician may wish to encourage a patient to invite a family member or friend to attend the discussion. The Supreme Court of Canada set limits on the non-therapeutic and therapeutic sterilization of mentally incapable incompetent patients. In the s, the mother of Eve petitioned the courts to allow the sterilization of her daughter, known by the pseudonym Eve. Eve was 24 years old and mildly to moderately intellectually disabled.
She lived with her year-old mother. Eve did not understand the "consequential relationship between intercourse, pregnancy and birth," and was considered incapable of providing consent to sterilization.
Eve lived much of the time at a special school, and there had been concern that she was developing a close relationship with a male student. Accessed on December 27, Valid consent.
The picture shows the psychologist of the Hellenic Society of Pain Management and Palliative Care — one of our institutional members - talking to a young patient during one of the palliative care team visits. How consent is given Consent can be given: verbally — for example, a person saying they're happy to have an X-ray in writing — for example, signing a consent form for surgery Someone could also give non-verbal consent, as long as they understand the treatment or examination about to take place — for example, holding out an arm for a blood test.
Consent should be given to the healthcare professional responsible for the person's treatment. This could be a: nurse arranging a blood test GP prescribing new medication surgeon planning an operation If someone's going to have a major procedure, such as an operation, their consent should be secured well in advance so they have plenty of time to understand the procedure and ask questions.
Consent from children and young people If they're able to, consent is usually given by patients themselves. Find out more about how the rules of consent apply to children and young people When consent is not needed There are a few exceptions when treatment may be able to go ahead without the person's consent, even if they're capable of giving their permission.
They should consider: what the person's quality of life will be if treatment is continued how long the person may live if treatment is continued whether there's any chance of the person recovering Treatment can be stopped if there's an agreement that continuing treatment is not in the person's best interests. The case will be referred to the courts before further action is taken if: an agreement cannot be reached a decision has to be made on whether to stop treatment for someone who's been in a state of impaired consciousness for a long time usually at least 12 months It's important to note the difference between stopping a person's life support and taking a deliberate action to make them die.
For example, injecting a lethal medicine would be illegal. Complaints If you believe you have received treatment you did not consent to, you can make an official complaint.
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