Ethics
Consent to Treatment
- A doctor has no legal right to treat a patient without that patients consent
- To do so would be: (1) a criminal offence (2) a civil wrong (3) a disciplinary matter
- In order to give consent a patient must be capable.
- Capability is determined by the ability to (a) understand information relevant to a decision (b) retain that information (c) weigh information as part of a decision making process and (d) communicate that decision. A person suffering from a mental disorder will not necessarily lack capacity
Rules for children
- A child is someone who is under the age of 18
- Children over 16 are presumed capable of giving valid consent as if they were an adult - but refusal is not binding (if the treatment is in the childs best interest, refusal can be overridden by someone with parental responsibility or the court)
- Children under the age of 16 are capable of giving consent because they are sufficiently mature to understand the nature of the decsision "Fraser competent" - and refusal may still be overridden
Informed consent
- Patient must be given sufficient information about the procedure
- "sufficient" - enough to enable the patient to understand the nature, likely effects and risks of treatment including the prospects for success and any alternatives
- The patient does not need to be informed of all possible risks
The Bolam Principle
"... he is not guilty of negligence if he has actied in accordance with a practice accepted as proper by a responsible body of medical men skilled in that particular art... a man is not negligent, if he is acting in accordance with such practice, merely because there is a body of opinion who would take a contrary review"