Informed Consent

Question 1

Describe informed consent as a right and the components of information and voluntary*

Answer 1

Informed consent is a patient right - it requires full disclosure and understanding of all information to ensure they fully understand their condition, options, benefits, and risks

Informed consent is voluntary and it must be free of coercion, force, manipulation, or influence

Question 2

Describe the paternalism approach that was historically used for consent*

Answer 2

The doctor made the decisions for their patients, as they were seen as the expert who would make decisions in the best interest of their patients

Question 3

What is the nurses 4 primary roles in informed consent?*

Answer 3

1. advocate for the patient, especially those who are not fully informed, require more time to reflect on alternatives, and whose wishes have not been respected
2. ensure all information necessary to make the choice has been provided
3. witness signature on consent forms
4. honor patient choices

Question 4

When is informed consent simpler?*

Answer 4

When the plan involves low risk and high certainty success (i.e., consent for a BP)

Question 5

Higher risk and invasive procedures require more comprehensive ___ process and ___ for the client to consider options*

Answer 5

Consent, time

Question 6

What six things are required for consent to be valid?*

Answer 6

1. person must be legally capable of making the decision
2. person must demonstrate that this information is understood
3. person must be assured that the decision is totally voluntary
4. process must be free of deceit or coercion
5. consent may be withdrawn at any time
6. person has the right to refuse consent, even if the proposed intervention is in their best interests

Question 7

What three factors limit autonomy?*

Answer 7

1. client is incapable of making decisions
2. there is evidence of causing harms to oneself and/or others
3. unreasonable, futile, or illegal request

Question 8

True or false: The nurse’s signature means that the nurse will be performing the procedure and that the nurse has described the risks/alternatives*

Answer 8

False

Question 9

Describe expressed and implied consent*

Answer 9

Expressed - verbally agreeing to the action

Implied - holding out their arm when you ask to take BP

Question 10

True or False: Clients who lack capacity to consent for themselves should be encouraged to participate in decision-making, as they are able*

Answer 10

True

Question 11

What four things indicate an individual’s capacity to decide?*

Answer 11

1. Have the ability to understand all information
2. Have the ability to communicate understanding and choices
3. Have personal values and goals that guide the decision
4. Have the ability to reason and deliberate

Question 12

Describe an advanced directive*

Answer 12

Enabling a mentally competent person to plan for a time when they may lack the mental capacity to make treatment decisions

Question 13

Describe power of attorney*

Answer 13

Person appointed make decisions limited by the authority contained in the document

Question 14

Describe Proxy*

Answer 14

Person appointed as health care agent to make treatment decisions

Question 15

Describe a living will*

Answer 15

Detailed instructions that the client has made; take effect when the client is no longer capable to make decisions for themselves

Question 16

Define a proxy directive/substitution decision maker*

Answer 16

Designating someone to make decisions on your behalf when you no longer have the capacity to do so

Question 17

Define instruction directive*

Answer 17

instructions that declare what kinds of treatment you do or do not want; provides direction to the SDM

Question 18

What is the 4-step hierarchy for a substitute decision-maker in legislation?*

Answer 18

1. Proxy identified by the person in advance, through an advance directive, power of attorney for personal care
2. Next of kin
3. legally appointed decision-maker
4. court appointed guardian

Question 19

What 4 elements are required to be eligible to be a substitute decision maker?*

Answer 19

1. at least 16 years of age
2. capable of making a decision with respect to the treatment
3. not prohibited by court order
4. available, and willing to assume the responsibility of giving or refusing consent

Question 20

How is capacity for consent deemed for children?*

Answer 20

The capacity of the child will depend on each child’s age, intelligence, maturity, experience, and other factors