Prerequisites
- Information – must be appropriate to pt’s circumstance, personality, expectations, fears, values, beliefs, cultural background
- Competence – requires that pt understands information given, remembers information given, and can analyse it to make a decision to give consent.
- Understanding
- Willingness
- Voluntary
- Lack of coercion
All adults over age of 18 are considered to have capacity unless proven otherwise.
If in doubt, mini-mental or formal neuropsychiatric testing may be needed.
Exercise
Take a surgical consent for an emergency appendicectomy from
- a 24 year old patient
- a 14 year old patient
- a 78 year old patient
Marking
Explain procedure
- Reason operation is needed
- Brief description of operation – laparoscopic, with risk of open
- Risks of operation – bleeding, infection, conversion to open, failure of operation, damage to surrounding organs, need for transfusion
- Risks of NOT operating – sepsis/death
Explain to patient that consent is voluntary at all times
Must check understanding of patient
Must ask if patient has any questions
Preferred: shows patient where incisions are to be (roughly). Diagram of appendix location can be useful.
