Consent in Adults

Capacity and Competence

Capacity

Ability to make an autonomous decision, at a given time.

Autonomy depends on Capacity.

4 Principles. 1 down(autonomy). Act on 3 remaining. Beneficence, Non-maleficence, Justice.

Assess, Never Assume Lack: Provide all support necessary, resources. Capacity to make some decisions, perhaps not all

Assess, if reason to suspect compromise: Vulnerable patients, erratic decision making. Important in decisions that are life-threatening.

Eg. Arskaya Vs Ukraine. Doctors took Mental patients decision into account. Violated ECHR.

Dynamic - Capacity can vary, over time condition fluctuates.

Independent - Capacity does not require them to arrive at a rational decision, simply that they consider factors to produce a decision

Impairment - Mental disorder, chronic pain, overwhelming emotion, Temporary factors: Fear, pain, shock, fatigue, drugs, confusion.

Capacity DOES NOT allow people to demand a specific treatment, only decide between options.