Thursday, 12 June 2008

examples regarding consent and capacity

Examples from GMC

Consent: patients and doctors making decisions together.

Refusal of treatment:

C had paranoid schizophrenia and was detained in Broadmoor Secure hospital. He developed gangrene in his leg but refused to agree to an amputation, which doctors considered as necessary to save his life .the court uphold C’s decision.

→ the fact that a person has a mental illness does not automatically mean they lack capacity to make decision about medical treatment.

Right of a patient who has capacity to refuse life-prolonging treatment:

B was 43 years old woman who had become tetraplegic and who no longer wished to be kept alive by means of artificial ventilation .she asked for ventilation to be withdrawn but the doctors caring for her were un willing to agree to this.B whose mental capacity was unimpaired by her illness, sought and obtained a declaration from the court that the hospital was acting unlawfully.

A competent patient has the right to refuse treatment and their refusal must be respected, even if it results in their death.

Right to refuse treatment even if it resulted in harm to unborn child:

S was diagnosed with pre-eclampsia requiring admission to the hospital and induction of labour, but refused treatment because she did not agree with medical intervention in pregnancy. Although competent and not suffering from a serious mental illness, S was detained for assessment under the mental health act .A judge made a declaration overriding the need for her consent to treatment, and the baby was delivered by caesarean section.

The appeal court held that S’s right to autonomy had been violated, her detention had been unlawful (since it has been motivated not by her mental state but by the need to treat her pre-eclampsia) and that the judicial authority for caesarean section had been based on false and incomplete information.

A competent pregnant woman can refuse treatment even if that refusal may result in harm to her or her unborn baby. Patients can not lawfully be detained and compulsorily treated for a physical condition under the term of the mental health act.

Can you add more example?

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