Case: Consent and Capacity - Basic case - discussion


Case: Consent and Capacity - Basic case - discussion

Team: Clinical Ethics in Emergency Medicine

Date: This is not a timed event.


1) What are the elements of an informed consent?

Elements of consent - Decision-making capacity, disclosure, understanding, voluntariness


2) What potential risks and benefits would you need to discuss with this patient?

Consent discussion should include - 

  a) the proposed procedure or intervention - what it is designed to do and why we are doing it - LP - discuss it further

  b) all other reasonable options, including doing nothing

  c) the anticipated benefits  - rule out a serious disease - subarachnoid haemorrhage presumed due to aneurysm

  d) the common risks - local pain and discomfort with procedure, recovery time, post-spinal headache

  e) rare or uncommon risks if they are significant (i.e. death or disfigurement) - epidural hematoma or abcess, trauma to nerve root, ?

  f) and need to know enough about the patient to determine if there are other risks that are significant to them in their specific situation (reasonable patient standard - from Reibl v Hughes legal case)


3) How would you document this discussion?

The discussion should be documented in your clinical notes. The patient does not necessarily need to sign a specific consent form.  

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