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Capacity for Consent - How Much Do We Know About It?

Capacity for Consent - How Much Do We Know About It?. Kate Evans Specialist Registrar in Emergency Medicine Derriford Hospital, Plymouth. Outline. Background Study methods Results Discussion Conclusions. Why did I look at this?. Working in ED Masters in Medical Law

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Capacity for Consent - How Much Do We Know About It?

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  1. Capacity for Consent - How Much Do We Know About It? Kate Evans Specialist Registrar in Emergency Medicine Derriford Hospital, Plymouth

  2. Outline • Background • Study methods • Results • Discussion • Conclusions

  3. Why did I look at this? • Working in ED • Masters in Medical Law • Mental Capacity Act • Previous study

  4. Capacity • What does this mean? • Why this is important to us? • NICE “All healthcare professionals who have contact, in the emergency situation, with people who have self-harmed should be adequately trained to assess mental capacity and to make a decision about when treatment and care can be given.”

  5. Re C In order to make a decision a patient must be able to • Take in and retain information • Believe it • Weigh that information, balancing risks and needs Mental Capacity Act

  6. Study methods • doctors (42), • nurses (21) and • ambulance staff (23) in ED in Birmingham

  7. Questionnaire • What three points would you look for in assessing one’s capacity to give valid consent? • Take in and retain information • Believe it • Weigh that information, balancing risks and needs

  8. Questionnaire • If a competent adult refuses medical treatment that you are proposing can you still treat them under common law? • NO

  9. Questionnaire • If someone is deemed incapable of signing a consent form for a procedure, is it legally necessary to get a relative to sign it instead? • NO

  10. Questionnaire • Should the Mental Health Act be used to treat physical illness when someone with a mental disorder is refusing treatment? • NO

  11. Results • What three points would you look for in assessing one’s capacity to give valid consent?

  12. Results • If a competent adult refuses medical treatment that you are proposing can you still treat them under common law?

  13. Results • If someone is deemed incapable of signing a consent form for a procedure, is it legally necessary to get a relative to sign it instead?

  14. Results • Should the Mental Health Act be used to treat physical illness when someone with a mental disorder is refusing treatment?

  15. Discussion • We are leaving ourselves open to criticism and legal action • It is not always easy • Varies for the decision being made • Altered by drugs, alcohol and emotional distress

  16. What should we do? • Most patients will consent to treatment • If patients don’t consent then an assessment of capacity must be made • If the patient has capacity then their decision must be respected • If the patient lacks capacity then they can be given treatment which is in their best interests • If there is doubt err on the side of caution

  17. Study conclusion • More training is needed!!

  18. Any Questions

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