Consent quiz - Answers

False
Although completion of a consent form in most cases is not a legal requirement, the use of such forms is good practice where intervention such as minor surgery is to be undertaken. Exceptions include abortion and certain treatments under the Mental Health Act.

False
If you are the doctor providing treatment or undertaking an investigation, it is your responsibility to discuss it with the patient and obtain consent as you will have a comprehensive understanding of the procedure or treatment, how it is carried out and the risks attached to it. Where this is not practicable, you may delegate these tasks to someone who is suitably trained and qualified, and has sufficient knowledge of the procedure and understands the risks.

False
Doctors may withhold details of treatment and attendant risks if disclosure would be likely to cause serious harm to the mental or physical health of a patient. However, this is not licence for paternalistic medicine. The emphasis is on the likelihood of disclosure causing serious harm.

False
Information leaflets are a valuable adjunct to counselling prior to treatment. Numerous studies have demonstrated how little information may be retained by patients following a consultation, particularly when they are anxious, or have just received bad news. Using illustrations during the counselling process and providing written information to patients is therefore valuable, but must never be seen as a replacement for adequate discussion between doctor and patient.

True
The information which patients want or ought to know before deciding whether to consent to treatment or an investigation may include:

• Explanations of the likely benefits 
• The probabilities of success
• Discussion of any serious or frequently occurring risks, and of any lifestyle changes which may be caused by, or necessitated by the treatment
• Alternatives.

True
If the process of seeking consent is to be a meaningful one, refusal must be one of the patient’s options. A competent adult is entitled to refuse any treatment except in circumstances governed by the Mental Health Act 1983. However, the situation for children is more complex. If, after discussion of all treatment options, a patient refuses all treatment, this fact should be clearly documented in the notes.

True
A competent person can nominate a person to make decisions for them, for example, when setting up an Lasting Power of Attorney in accordance with the Mental Capacity Act (2005). It would be rare for a competent person to nominate another person to make decisions at a time when they had capacity.

True
In an emergency, where consent cannot be obtained, you may provide medical treatment to anyone who needs it, provided the treatment is limited to what is immediately necessary to save life or avoid significant deterioration in the patient’s health.

True
It is important to remember that consent is a process and that consent is required for absolutely every physical examination, referral etc.

• Explain what needs to be done and why
• Explain what the examination will entail
• Obtain the patient’s permission
• Offer a chaperone, or the patient’s companion of choice, and document this. 

False
“Provided that the patient, whether a boy or girl, is capable of understanding what is proposed, and of expressing his or her own wishes, I see no good reason for holding that he or she lacks the capacity to express them validly and effectively and to authorise the medical man [sic] to make the examination or give the treatment which he advises.” Extract from Gillick v Wisbech Area Health Authority 1986.

True
You must respect any refusal of treatment given when the patient was competent, provided the decision in the advance statement is clearly applicable to the present circumstances, and there is no reason to believe that the patient has changed his/her mind.

True
You must respect a patient’s decision to refuse an investigation, or treatment, even if you think their decision is wrong. Explore your concerns and the positive consequences to the patient, but do not pressurise them.