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inform concent
legal & ethical issues in nursing chap 7
| Question | Answer |
|---|---|
| Consent is based on a | contractual relationship that arises through mutual consent of parties to the relationship |
| Informed consent is | the voluntary authorization |
| Informed consent | Mandates to the physician or independent health care practitioner, Legal duty to disclose needed material facts, Information in terms patients can reasonably understand |
| Informed refusal | Disclosing what would happen if the patient refuses treatment |
| Expressed or implied | Inferred by the patient’s conduct or that which may legally be presumed in emergency situations, For minors |
| Orally | Inherent risks in proving consent |
| Written | Most often required in health care situations |
| Partial or Complete | Patient authorizes only a portion of the procedure |
| Reasonable Medical Practitioner Standard | Fluid and changing, Based on prevailing medical thought and community, Patient must be told of inherent risks, Disclosures must cover possible serious injuries |
| Prudent Patient standard | What a prudent person in the given patient’s position would deem material |
| Malpractice suits based on informed consent must show: | The provider had a duty, There was a breach of duty to disclose, Reasonable patient standard was not met |
| Exceptions | Emergency situations, Therapeutic privilege, Patient waiver, Prior patient knowledge |
| Accountability | Physician, Independent practitioner, Hospitals |
| Nurse’s Role in Obtaining Consent | Most nursing interventions rely on oral expressed consent or implied consent, Nurses must continually communicate with patients |
| Blanket consent | for routine and customary care |
| Specific consents | Signature of patient or legal representative, Procedure, Risks and alternatives, Probable consequences, Signatures of one or two witnesses |
| Things for the nurse to remember | Witnesses are not required to make the consent valid, Consent may be withdrawn at any time |
| Who must give consent | Competent Adult, 18 years of age |
| Minors | Child under 18 |
| Right to refuse consent | Continues even after primary consent is given, Law of continuance allows if stopping therapy poses too great of harm |
| Limitations on Refusal of Therapy | Preservation of life, Protection of minor dependents, Prevention of irrational self-destruction |
| Law Enforcement | Issues in the collection of evidence and the patient’s right to refuse |
| Human Experimentation | Using vulnerable groups for research purposes, 1974 Department of Health and Human Services require formation of institutional review boards (IRBs) |
| Medical Illiteracy | Growing inability of individuals to understand medical terms and instructions |
| Genetic Testing | Informed consent, Discrimination against persons with less than perfect genes, Confidentiality of genetic testing |
| Issue of Informed Consent | Competent adults have the right to refuse medical treatment, The state can intervene |
| Living Wills | Started in 1960s, Directives from competent individuals to family and medical personnel their wishes to receive care when they can no longer make the decision for themselves |
| Natural Death Acts | Specific type of living will enacted into law, Legally recognized living wills with statutory enforcement, All state have some form of natural death legislation |
| Do-Not-Resuscitate Directives | Patients can request, New York, Georgia, and West Virginia are states that address do-not-resuscitate orders |
| Durable Power of Attorney for Health Care (DPAHC) | Appointment of a surrogate or proxy to make health care decisions |
| Medical or Physician Directives | Directives that list a variety of treatments and let patients decide what they want |
| Uniform Rights of the Terminally Ill Act | Adopted in 1989, Sole purpose is to provide alternative ways the terminally ill patient’s desires can be legally implemented |
| Patient Self-Determination Act of 1990 | Enacted into law in 1991 as part of the Omnibus Budget Reconciliation Act of 1990, Patients must be queried about the existence of advanced directives |
| Hospice Care | Prevents the need for natural death acts and living wills, Allows patients to receive the nursing and medical care required to keep them comfortable |
| Assisted Suicide | Most states still prohibit ,Some consider it criminal but some prohibit only causing suicide, not assisting it |
| Assisted Suicide | Oregon is the only state with such a statute, Death with Dignity Act 1994, Allows physicians to write lethal drug prescriptions for competent terminally ill adults who are residents of the state |
Created by:
rcline@
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