Consent

Question 1

Law - Fraser guidelines

Answer 1

Gillick competency and Fraser guidelines

• competence of a child <16 y/o to consent to his/her own medical care
• a child is someone less than 18 y/o
• persons who usually consent for child = mother and father as named on birth certificate if born after 2003, or mother if born before 2003

Question 2

Fraser guidelines

Answer 2

Require healthcare professionals to assume everyone has the capacity unless proven otherwise

Question 3

How is capacity assessed?

Answer 3

Giving patients information and ensuring they are able to:

1. understand,
2. retain,
3. weigh up the options and
4. communicate back a decision
   - must be rechecked each time (may be periods of lack of capacity interspersed with periods of capacity)

Question 4

Mental capacity act 2005

Answer 4

• allows < 16 y/o and lack capacity to be protected and empowered to make their own decisions
• if a person lacks capacity, help a decision to be made in that persons best interest
• decisions should be least restrictive of the affected persons basic rights
• allows for an ‘independence advocate’ or person provided to support decision making especially if it may significantly restrict the affected persons wellbeing

Question 5

Who may lack capacity?

Answer 5

• Dementia
• Stroke
• Mental health issues
• Learning disabilities

Question 6

Healthcare professionals must support decision making by thinking about:

Answer 6

• has all relevant information been given?
• could information be presented more easily?
• have all the alternatives been considered
• can others help with communication
• can the decision be delayed
• can decisions be made at better times during the day or in a better environments?
• have other methods of communication been explored

Question 7

Who can help with decision making?

Answer 7

• Guardians
• those previous named by the patient
• those who take an interest in their welfare
• those granted lasting power of attorney
• those granted enduring power of attorney
• a deputy appointed by court of protection

N.b. Those with power of attorney must make sure the mental capacity act principles are followed if the pt doesn’t have valid capacity, enduring power of attorney are valid from before the date when the mental capacity act came into force (oct 2007)