Decisions Made and Not Made: Responsibilities and Rites in Consent to Treatment

1986 ◽  
Vol 31 (3) ◽  
pp. 220-221
Author(s):  
Alan B. Hawk
Keyword(s):  
2019 ◽  
Vol 59 (4) ◽  
pp. 247-254 ◽  
Author(s):  
Gabriele Mandarelli ◽  
Giovanna Parmigiani ◽  
Felice Carabellese ◽  
Silvia Codella ◽  
Paolo Roma ◽  
...  

Despite growing attention to the ability of patients to provide informed consent to treatment in different medical settings, few studies have dealt with the issue of informed consent to major orthopaedic surgery in those over the age of 60. This population is at risk of impaired decision-making capacity (DMC) because older age is often associated with a decline in cognitive function, and they often present with anxiety and depressive symptoms, which could also affect their capacity to consent to treatment. Consent to major orthopaedic surgery requires the patient to understand, retain and reason about complex procedures. This study was undertaken to extend the literature on decisional capacity to consent to surgery and anaesthesia of patients over the age of 60 undergoing major orthopaedic surgery. Recruited patients ( N=83) were evaluated using the Aid to Capacity Evaluation, the Beck Depression Inventory, the State–Trait Anxiety Inventory Y, the Mini-Mental State Examination and a visual analogue scale for measuring pain symptomatology. Impairment of medical DMC was common in the overall sample, with about 50% of the recruited patients showing a doubtful ability, or overt inability, to provide informed consent. Poor cognitive functioning was associated with reduced medical DMC, although no association was found between decisional capacity and depressive, anxiety and pain symptoms. These findings underline the need of an in-depth assessment of capacity in older patients undergoing major orthopaedic surgery.


Author(s):  
Yeun-Joo Hur ◽  
Joon-Ho Park ◽  
MinKyu Rhee

This study was conducted to evaluate the competency to consent to the treatment of psychiatric outpatients and to confirm the role of empowerment and emotional variables in the relationship between competency to consent to treatment and psychological well-being. The study participants consisted of 191 psychiatric outpatients who voluntarily consented to the study among psychiatric outpatients. As a result of competency to consent to treatment evaluation, the score of the psychiatric outpatient’s consent to treatment was higher than the cut-off point for both the overall and sub-factors, confirming that they were overall good. In addition, the effect of the ability of application on psychological well-being among competency to consent to treatment was verified using PROCESS Macro, and the double mediation effect using empowerment and emotional variables was verified to provide an expanded understanding of this. As a result of the analysis, empowerment completely mediated the relation between the ability of application and psychological well-being, and the relation between the ability of application and psychological well-being was sequentially mediated by empowerment and emotion-related variables. Based on these findings, the implications and limitations of this study were discussed.


2007 ◽  
Vol 6 (4) ◽  
pp. 217-223
Author(s):  
Gillian Thompson

AbstractThis paper explores some of the issues around implementing a consent policy within the radiotherapy department. Consent can be defined as a patient’s agreement for a health care professional to provide care. The NHS Plan1 highlighted the need for quality care centred around the patient and for changes in the way patients are asked to give their consent to treatment. This led to the Department of Health (DoH) publishing a Good Practice in Consent Implementation Guide (2001)2 for use within all NHS Trusts from 1 April 2002, which aimed to provide consistency across the NHS and provides a policy model and generic consent forms.The policy recommends that the health professional carrying out the procedure is ultimately responsible for ensuring that the patient is genuinely consenting to what is being done, as it is they who would be held responsible in law should a case be made by a patient against a health professional. In radiotherapy, it is the Clinical Oncologist who obtains consent as they are responsible for prescribing courses of treatment; however, it is the Radiographer’s role to deliver this treatment. This paper discusses some of the issues around implementing a consent policy in terms of who can give and confirm consent, and what are the requirements for training if the patient is to receive the appropriate information before making the decision to consent to treatment.


1999 ◽  
Vol 23 (10) ◽  
pp. 578-581 ◽  
Author(s):  
Trevor Turner ◽  
Mark Salter ◽  
Martin Deahl

Psychiatrists have been complaining about mental health legislation for over a century (Smith, 1891), usually in terms of the delays engendered, paperwork and bureaucracy, and the impositions on clinical practice. As a result they have gained more powers, and perhaps much-needed status within the medical profession, to the concern of some commentators (e.g. Fennell, 1996). Thus, the ‘triumph of legalism’ (Jones, 1993) of the Lunacy Act 1890 was modified by the Mental Treatment Act 1930, whereby outpatients and voluntary patients were encouraged and ‘asylums' became ‘mental hospitals'. Then came the radical change of the Mental Health Act (MHA) 1959, making compulsory detention an essentially medical decision and removing the routine of the courts, but retaining a theme of requiring ‘treatment in hospital’. The Mental Health Act 1983, however, was a touch anti-medical, since it strengthened the role of the approved social worker (ASW) and enhanced the importance of a patient's consent to treatment. “The primacy of the medical model and the paramountcy of the psychiatrist are certainly subject to greater limitations and external review”, was the opinion of William Bingley, then Mind's Legal Director, now Chief Executive of the Mental Health Act Commission – reviewing the Act in its early days (Bingley, 1985).


2003 ◽  
Vol 43 (2) ◽  
pp. 132-135
Author(s):  
D Nelson ◽  
M Wright ◽  
I Walsh ◽  
K Moody ◽  
L Beveridge

JAMA ◽  
1985 ◽  
Vol 253 (6) ◽  
pp. 778 ◽  
Author(s):  
Spencer Eth
Keyword(s):  

1990 ◽  
Vol 35 (4) ◽  
pp. 285-289 ◽  
Author(s):  
Ronald. J. Draper ◽  
David Dawson
Keyword(s):  

Sign in / Sign up

Export Citation Format

Share Document