Capacity and Consent

Question 1

What is valid consent?

Answer 1

Given freely without duress or coercion 
Legally capable of consenting
Cover the intervention/ procedure
Informed
Enduring

Question 2

What should be considered when obtaining consent?

Answer 2

What the treatment consists of
Main beneficial effects
Risks and unwanted side effects
Consider; written/ visual aids, translators, friends/relatives, time to reflect

Question 3

What is capacity?

Answer 3

Ability to make a decision

Question 4

Can you lack capacity for one decision but retain it for others?

Answer 4

Yes; must be reevaluated for every decision made

Question 5

What must you possess to have capacity?

Answer 5

Understand and retain relevant information
Use and weigh that information to make a decision
Communicate that decision

Question 6

What are the principles of the adults with incapacity act (AWI)

Answer 6

Intervention must benefit adult
Such benefit cannot reasonably be achieved without intervention
Take account of past and present wishes
Consult with other relevant persons
Encourage the adult to use residual capacity

Question 7

What is the AWI section 47 certificate?

Answer 7

Authorises practitioner to provide reasonable interventions related to the treatment authorised
DOES NOT authorise force unless immediately necessary and only for as long as is necessary

Question 8

When is AWI section 47 used?

Answer 8

Authorise treatment of a physical disorder in someone without capacity to consent to that treatment

Question 9

When are power of attorneys granted?

Answer 9

Whilst patient has capacity

Question 10

What will power of attorneys act for?

Answer 10

Financial or welfare

Can be both

Question 11

What is guardianship?

Answer 11

Occurs when someone has lost capacity to grant a power of attorney
Granted by the sheriff

Question 12

Can a welfare guardian place an adult in a hospital for treatment of a mental disorder against their will?

Answer 12

No; use MHA

Question 13

What can be done if someone is not compliant with the wishes of a welfare guardian?

Answer 13

Sheriff can issue a compliance order

Question 14

What does the MHA allow for?

Answer 14

Treatment of mental disorder or physical consequences of a mental disorder in someone without capacity to consent to treatment

Question 15

Different types of MHA

Answer 15

Emergency detention certificate (sec 36)
Short term detention certificate (sec 44)
Compulsory treatment order

Question 16

Criteria for emergency detention section 36?

Answer 16

Likely to have a mental disorder
Significantly impaired decision making ability regarding treatment due to a mental disorder
Detention in a hospital is necessary to determine treatment
Risk of health, safety or welfare to the patient or others
Making arrangement for sec 4 would involve undesirable delay

Question 17

At what age can children legally make decisions?

Answer 17

16
BUT
Use gillick competence

Question 18

Is there a lower age limit for the MHA?

Answer 18

No

Question 19

When should a MHA be utilised vs parental consent?

Answer 19

Use of force
Use of IM medication
Certain treatments; NG feeding, ECT
Detrimental impact on relationship with carer