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Informed consent in healthcare
Informed consent in healthcare
Factors influencing consent in health
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Consent is where a person provides either written, verbal or implied authorisation for something to happen (“Consent”, n.d.). Before any medical procedure, treatment or operation, the health care professional must gain consent from the patient. Under New South Wales law, failing to gain consent prior to medical treatment can result in legal action being taken and the health care professional being charged with assault and battery (NSW Government, 2005). For consent to be valid and legal, the patient receiving the treatment must be informed of, and completely understand their condition and the reason for their treatment in order to make the most appropriate and informed decision without any influence or pressure from others; the person must be informed of, and understand all the risks …show more content…
It is the health care professionals duty of care to provide all information in regards to treatment to the patient (NSW Government, 2005). If a person is not capable of giving giving consent due to being under age, mental illness, cognitive impairment or being unconscious, there are alternate options available to assist a person to express there health care preferences for instance, in the case of a child, a parent or guardian could consent to medical treatment on their behalf or in the case of an adult with cognitive impairment, an advance care directive could be beneficial in this situation. An advanced care directive or a living will, is a legal document that contains a person 's wishes or instructions in regards to their future health care or their end of life care. In an advance care directive, a surrogate decision maker can also be nominated to make decisions on the patient 's behalf (Cartwright,
Autonomy is a concept found in moral, political, and bioethical reasoning. Inside these connections, it is the limit of a sound individual to make an educated, unpressured decision. Patient autonomy can conflict with clinician autonomy and, in such a clash of values, it is not obvious which should prevail. (Lantos, Matlock & Wendler, 2011). In order to gain informed consent, a patient
Consent is necessary from everyone, not only those who can verbalise his or her needs. It is important to find out the persons communication needs so that they can be involved in discussions around their needs and preferences. My duty of care is to ensure that choices are given, and that appropriate support is obtained where there is lack of capacity is the decision is complex and the individual cannot consent. This may be from families or next of kin or using advocates to ensure that the client’s best interests are maintained. There may be past events or requests that could indicate the client’s preferences, and these must be considered when choices have to be made by others. Any preferences should be recorded on care plans and shared with relevant others to be able to determine the best interests of the person. Decisions should also be put off until the client is able to make their own choices where possible and not taken on their behalf through assuming we know
In Amira’s case, an issue of consent is arisen that her GP has not explained to her much about the conditions she is suffering and the medication that he prescribed. Amira was left a little confused because she did not has the chance to ask questions. For obtaining consent, it must be informed and capacity which means that Amira must be given all of the information of the treatment and they understand the information provided by the doctor and they can use it to make a decision (13). Obtaining consent will lead to enhancement of the efficiency to the treatment because Amira is happy and showing agreement to the
No healthcare professional or hospital can force a person to make an advance directive if they do not want one. Although they are extremely encouraged, hospitals and doctors may not discriminate against anyone that does not have an advance directive. Advance directives are more so that the patient has a say in their end-of-life care even if they are unable to make the decisions at that time. It is helpful for doctors and other healthcare professionals because it allows them to provide better patient-centered care. If a person does not have an advance directive, the state of Indiana allows any member of the person’s immediate family or someone appointed by the court to make decisions for them. A person will get care more suitable for their personal beliefs if they write a living will or have a power of attorney.
Prior to discussing why Advanced Directives are so essential the definition of Advanced Directives is crucial. An Advanced Directive is made up of several legal components which ultimately online the patient’s wishes if one was to be incapacitated or unable to verbally make wishes know regarding healthcare. The understanding of what a living will and a durable power of attorney both need to be discussed before one is able to compare and contrast. A living will ensures that anyone reading this paper will understand how the patient wanted to continue their form of treatment. With a living will anyone ranging from patients to healthcare professions should be able to determine the specific actions the patients would want taken if they are unable to make said wishes known. A
In this context, new emphasis is being placed on the rights of patients. Recent federal legislation, for example, requires all health care facilities receiving Medicare or Medicaid monies to inform patients of their right to make medical treatment decisions. This includes the right to specify "advance directives," [1] which state what patients wish to be done in case they are no longer able to communicate adequately.
Social Attitudes Survey noted that 78% of respondents believe that “the law should require doctors to carry out the instructions of a Living Will” (Park et al, 2007). These decisions become important once patients lose their mental capacity, are unconscious, or unable to communicate” (BMA, 2009). The Mental Capacity Act 2005 defines an “advance decision” as a decision made by a person 18 or over, when he or she has the capacity to do so. The implications of a Living Will, make the case against legalising assisted dying weaker. This is because if a person is legally allowed to set out which treatments they will or will not agree to, and can refuse life sustaining treatments by creating a legal document, then why shouldn’t an individual in extreme pain who is able to make the request at the time be able to ask for assistance in
According to the NICE (2015) health and social care professionals should always seek valid consent from people with dementia. This should entail informing the person of options, and checking that he or she understands, that there is no coercion and that he or she continues to consent over time. If the person lacks the capacity to make a decision, the provisions of the Mental Capacity Act 2005 must be followed. The nurse assessed the patient capacity and ensured that the decision made was in the best interest of the patient. The doctor uses specialist knowledge and experience and clinical judgement, and the patient’s views and understanding of their condition, to identify which investigations or treatments are likely to result in overall benefit for the patient (GMC, 2008). They took into consideration how the decision made will benefit Jean. After carrying out a full assessment, it was clear that Jean lack capacity and was therefore place under the mental capacity act
Two examples of Advance Care Directives, which are living wills that allow a person to document end of life medical treatment, are the FiveWishes and MyDirectives in the United States. The FiveWishes directive is described as living with a heart and soul and follows five wishes. These wishes include: the person which will make decisions regarding the patient’s health when the patient is not able to, the kind of medical treatment wanted and not wanted, the level of comfortability of the patient, how the patient is treated, and the amount of information that the patient’s loved ones know. The MyDirec...
Consent is an issue of concern for all healthcare professional when coming in contact with patients either in a care environment or at their home. Consent must be given voluntary or freely, informed and the individual has the capacity to give or make decisions without fear or fraud (Mental Capacity Act, 2005 cited in NHS choice, 2010). The Mental Capacity Act perceives every adult competent unless proven otherwise as in the case of Freeman V Home Office, a prisoner who was injected by a doctor without consent because of behavioural disorder (Dimond, 2011). Consent serves as an agreement between the nurse and the patient, and allows any examination or treatment to be administered. Nevertheless, consent must be obtained in every occurrence of care as in the case of Mohr V William 1905 (Griffith and Tengrah, 2011), where a surgeon obtain consent to perform a procedure on a patient right ear. The surgeon found defect in the left ear of the patient and repaired it assuming he had obtained consent for both ear. The patient sued him and the court found the surgeon guilty of trespassing. Although there is no legal requirement that states how consent should be given, however, there are various ways a person in care of a nurse may give consent. This could be formal (written) form of consent or implied (oral or gesture) consent. An implied consent may be sufficient for taking observation or examination of patient, while written is more suitable for invasive procedure such as surgical operation (Dimond, 2011).
There are many legal and ethical concerns surrounding issues of the end of life. Healthcare providers and patient’s family members all must encounter with different point of views of these matters. Prepare a healthcare Advances Directive is a way a patient can ease many of the issues related with the decision to die with dignity. The two primary legal documents of Advance Directives include Living Wills and Durable Powers of Attorney. By implementing these document, patients can make their wishes about health care decisions to both healthcare providers and family members in the event they become incompetent or incapable of making health care decisions.
An advance health care directive or advance directive is a legal document that tells the doctor the wishes of a patient concerning health care. It provides a better chance of receiving the kinds of treatment a patient may or may not have when they are unable to voice those wishes to a doctor or family members. A patient may choose a living will, a medical directive, or a health care power of attorney or health care proxy, or a combination of the three.
According to Haley and Daley (2013), cancer as the main cause of the terminal illness in the paediatric age. For the recent years, the survival rates of children with cancer have increased significantly with 7 out of 10 recovers (Selwood, Langford, & Wright, 2012). Haley & Daley (2013) also mentioned that parents act as the decision-makers and as the primary carer, moreover, physical and psychosocial developmental factors of the child affects the perception of death as temporary and the capability to communicate and make their own decisions. Moreover, parents make the decision for the child as for legal matters, but the child needs encouragement to actively participate and to develop the sense of authority. Children may have a different idea of pain and illness, for instance, they may think that they did something wrong that is why they are suffering. Children may refuse or not participate properly in any treatment without the supervision of the primary carer. Providing the child and family with health education during palliation as well as helping them to the transition to adulthood is an important task for the nurse. Derby, Tickoo, and Saldivar (2014) mentioned that the major difference of between old and younger adults is the need for extensive support of the family. Decision-making for older people might include the patient’s family, surrogates and Advanced Care Planning (ACP) at the time they are not able to make their own decision. Derby et al., (2014) stated that “ACP prepares for lack of capacity in decision-making and relieves the burden of decision-making on others” and surrogate decision-maker “is a person whom the patient designates to make decisions if/when he or she is unable to do so”. Older patients need a representative, mostly an elderly act as a primary carer to make the decision for them or someone who will make
For consent to be valid an individual must consent to the procedure freely and voluntarily, hence consent should not be forced or obtained by assault or battery. When consent is given it must be specifically related to the procedure, this consent should not be manipulated and falsely described to a patient ability to make an informed decision refers to a person who has the legal capacity (NSW Health, 2014). Therefore the individual must have the capability to retain information that is given to them; for example the person must process the information, believe it and balance the risks and benefits of undergoing the procedure (NSW Health, 2014). Additionally, voluntary decision-makings give a right to the patient to refuse a procedure at anytime. Consequently, healthcare care staff are required to respect the patient’s desires, despite the fact that not taking action may lead to death or serious harm (NSW Health, 2014).
Informed consent is a very interesting subject. It helps sort the legitimate scientists and doctors from the corrupt ones, who are taking advantage of their patients. Even though it really shouldn’t be, informed consent is still a debated topic to this day, and both sides of the argument both have different yet reasonable points. Reasonable or not, there are many examples and cases through medical history where doctors didn’t take human rights under consideration, and did some very questionable testing. Although both sides of the argument are valid, having informed consent is the correct thing to do.