Healthcare and Medicine Reference
In-Depth Information
Box 2.1 Mental Capacity Act 2005 - Section 1
Box 2.2 Information required for consent
1
A person must be assumed to have capacity unless it is
You must give patients the information they want or need about:
the diagnosis and prognosis
established that they lack capacity.
A person is not to be treated as unable to make a decision unless
2
any uncertainties about the diagnosis or prognosis, including
all practicable steps to help him do so have been taken without
success.
A person is not to be treated as unable to make a decision merely
options for further investigations
options for treating or managing the condition, including the
3
option not to treat
the purpose of any proposed investigation or treatment and what
because he makes an unwise decision.
An act done, or decision made, under the Act for or on behalf of
4
it will involve
the potential benefi ts, risks and burdens, and the likelihood
a person who lacks capacity must be done, or made, in his best
interests.
Before the act is done, or the decision is made, regard must be
of success, for each option; this should include information, if
available, about whether the benefi ts or risks are affected by
which organisation or doctor is chosen to provide care
whether a proposed investigation or treatment is part of a
5
had to whether the purpose for which it is needed can be as
effectively achieved in a way that is less restrictive of the person's
rights and freedom of action.
research programme or is an innovative treatment designed
specifi cally for their benefi t
the people who will be mainly responsible for and involved in
If an adult patient lacks capacity they cannot consent for a
procedure: no one may give consent for the procedure in their stead
(apart from under a legally appointed Lasting Power of Attorney).
their care, what their roles are, and to what extent students may
be involved
their right to refuse to take part in teaching or research
their right to seek a second opinion
any bills they will have to pay
Information
any confl icts of interest that you, or your organisation, may have
any treatments that you believe have greater potential benefi t for
The General Medical Council (UK) makes recommendations about
the minimum amount of information a patient should be given in
order to give valid consent for a procedure (Box 2.2). As research
suggests that many patients have poor recall of oral information,
written information should ideally be provided.
The information should be delivered using clear, non-technical
language which the patient can understand. Consideration should
be given to the use of an interpreter if there is any doubt as to the
patient's ability to understand the healthcare professional due to a
language barrier.
Any questions about the procedure a patient may ask must be
answered in an open and honest manner.
In an emergency it may not be possible to give all the informa-
tion detailed in Box 2.2; however, the patient should be aware of the
purpose of the procedure, its potential side-effects and alternative
treatment strategies. Any questions they have must be answered.
the patient than those you or your organisation can offer.
Consent: patients and doctors making decisions together.
GMC, June 2008
Box 2.3 Conditions in which written consent is recommended
The investigation or treatment is complex or involves signifi cant risks.
There may be signifi cant consequences for the patient's
employment, or social or personal life.
Providing clinical care is not the primary purpose of the
investigation or treatment.
The treatment is part of a research programme or is an innovative
treatment designed specifi cally for their benefi t.
Consent: patients and doctors making decisions together.
GMC, June 2008
Voluntariness
Box 2.3 covers situations when written consent is particularly
recommended.
'You must use the patient's medical records or a consent form to record
the key elements of your discussion with the patient. This should include
the information you discussed, any specifi c requests by the patient, any
written, visual or audio information given to the patient, and details of
any decisions that were made'.
Consent: patients and doctors making decisions together .
The patient must agree to the procedure being proposed and not
feel pushed or coerced into the procedure. The healthcare profes-
sional must check that the patient is in agreement for the procedure
to go ahead. Particular care must be taken with patients in police
custody or detained under mental health legislation.
Recording consent
GMC, June 2008
If the above elements are present then a patient may consent to a
procedure.
Consent to medical treatment may be oral or written, expressed
or implied.
Standard consent forms are routinely used throughout medical
practice and ideally should be used for the majority of medical pro-
cedures - especially those with potentially serious side-effects.
When consent cannot be given
When an adult patient lacks capacity to give consent and no-one with a
legal power of attorney has been appointed (or cannot be contacted in
an emergency situation) then a senior healthcare professional will need
to decide what treatment is in the patient's best interest (Box 2.4).
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