HMI205 - Consent

What are the core elements of legally valid consent in healthcare?

• Decision making capacity - able to understand relevant information about a decision, remember the information sufficiently to process the decision, evaluate and communicate a decision.

  • Adults are assumed to have decision making capacity unless otherwise.

• Information - Has sufficient, relevant, current and accurate information to make a decision. i.e. risks and benefits, diagnosis, treatments.

• Understanding - Communication of relevant information such that understanding is confirmed.

• Voluntariness - Free from coercion and manipulation

• Person must be able to communicate their consent

Assent vs consent?

Consent requires the legal right and full understanding to give formal permission, whereas assent is a willingness to participate given by someone who cannot legally provide formal consent (such as a minor or a cognitively impaired individual

Whose responsibility is it to obtain consent for a medical imaging procedure?

The referring doctor as well as you. Make sure you tell the patient why you are doing an X-ray for them.

If a patient says “i guess i don’t really have a choice, do i"?”, what can you do to make sure u have valid consent from them?

• “U do have a choice, you can choose not to have this”

• Give them more time to think.

• Ask the referring doctor

When a person lacks decision-making capacity, what can you check?

• Previously made a plan (advance care directive) which may be used to inform decision making on their behalf

• May have a designated Medical Treatment Decision Maker

What are the different surrogate decision makers?

Appointed Medical Decision Maker

• Appointed by the individual

Victorian Civil and Administrative Tribunal (VCAT) appointed MDM

• Appointed by a guardian

Default DM

• Domestic partner

• Primary carer

• Adult child of the person

• Parent of the person

• Adult sibling of the person.

Public Advocate