Chapter 8: Consent to Treatment

Consent

1. A patient's acknowledgement that he or she understands a proposed intervention, including that intervention's risks, benefits, and alternatives; 2. A patient's agreement that protected health information can be disclosed; the document that provides a record of the patient's consent.

A person must give permission to receive medical treatment through express consent. True or False?

False, a person can also give permission through implied and informed consent or by other ways.

A decision to be an organ donor can only be made by an adult (person of legal age). True or False?

False.

A durable power of attorney for healthcare decisions expresses an individual's wishes to limit treatment measures when specific health-related diagnoses or conditions exist, and the individual cannot communicate on his own behalf. True or False?

False.

Institutional Review Board (IRB)

A committee of at least five members with varying backgrounds that determines the acceptability of proposed human subjects research in accordance with institutional policies, applicable law, and standards of professional practice and conduct.

Therapeutic Privilege

A doctrine that has historically allowed physicians to withhold information from patients in limited circumstances.

Living Will

A document executed by a competent adult that expresses that individual's wishes to limit treatment measures when specific health-related diagnoses or conditions exist.

General Consent

A form that covers routine diagnostic procedures and medical treatment by hospital staff, as well as other activities such as release of information for treatment purposes and disposal of human tissue and body fluids.

Patient Self-Determination Act

A law that became effective in 1991 requiring healthcare institutions that bill Medicare or Medicaid for services to provide adult patients with information about the various types of advance directives.

Advance Directive

A legal document that specifies an individual's healthcare wishes in the event that he or she has a temporary or permanent loss of competence.

Durable power of attorney for healthcare decisions (DPOA-HCD)

A legal instrument through which a principal appoints an agent to make healthcare decisions on the principal's behalf in the even the principal become incapacitated.

Power of Attorney

A legal instrument used by a principal (person) to grant legal authority to one or more agents to make certain legal and financial decisions on behalf of the principal.

Uniform Health-Care Decisions Act (UHCDA)

A model law created in 1993 that provides that an individual may give an oral or written instruction to a health care provider that remains in force even after the individual loses capacity, and suggests decision-making policy priority for that individual's surrogates.

Durable power of attorney (DPOA)

A power of attorney that remains in effect even after the principle is incapacitated; can be drafted to take effect only when the principal becomes incapacitated.

Do not resuscitate (DNR) order

A specific type of advance directive in which an individual states that healthcare providers should not perform CPR if the individual experience cardiac arrest or cessation of breathing.

Informed Consent

A type of consent in which the patient should have a basic understanding of which medical procedures or tests may be performed as well as the risks, benefits, and alternatives for those tests or procedures.

Uniform Anatomical Gift Act

An act that provides suggested standards for all aspects of organ donation, including who may make anatomical gifts and how intent to make anatomical gifts should be expressed--designed to create uniformity in this area across all 50 states.

National Research Act of 1974

An act that required the Department of Health, Education, and Welfare (now the Department of Health and Human Services) to codify its policy for the protection of human subjects into federal regulations and created a commission that generated the Belmont Report.

Competent Adult

An individual who has reached the age of majority and is mentally and physically competent to tend to his or her own affairs; may consent to treatment and may authorize the access or disclosure of his or her health information.

Incompetent Adult

An individual who is at or above the age of majority and becomes incapacitated due to an illness or injury, either permanently or temporarily; another person should be designated to make decisions for that individual, including decisions about the use and disclosure of the individual's protected health information.

Minor

An individual who is under the age of majority (usually 18 years of age) who has not been legally emancipated (declared an adult) by the court.

Implied Consent

Consent for medical treatment that is communicated through a person's conduct or some other means besides words.

Express Consent

Consent that is communicated through words, regardless of whether those words are written or spoken.

A healthcare organization can confidently follow the wishes expressed in a properly executed advance directive, even if the patient (who is competent) has changed his or her mind. True or False?

False.

An emancipated minor is one who has not been afforded legal status as an adult. True or False?

False.

Healthcare providers should encourage patients to waive consent. True or False?

False.

The technical process for executing a living will is standard nationally. True or False?

False.

If it is considered a springing DPOA for healthcare decisions, the agent will have decision-making power in all circumstances. True or False?

False. The principal can grant the agent on either making all the decisions or certain decisions and make more than one person as agents.

Age of Majority

In most states, the age of 18; an individual generally must have reached the age of majority in order to be considered a competent adult.

Short Form Consent

In the context of human subjects research, a written document stating that the elements of informed consent required by the Common Rule have been orally presented to and understood by the subject or the subject's legally authorized representative.

Long Form Consent

In the context of human subjects research, consent form that includes all of the informed consent requirements included in the Common Rule.

Capacity

Indicates that an individual is mentally competent and is in control of himself of herself.

Principal

Individual who signs a power of attorney giving an agent (person designated by the principal) to make certain decisions for the principal.

Non compos mentis

Not of sound mind; not mentally competent to handle one's affairs.

Emancipated Minor

One who is under the age of majority and is self-supporting, and who parents have surrendered their rights of custody, care, and support.

Agent

Person designated by an individual (principle) to make certain decisions or perform certain acts on the individual's behalf.

Federal Policy for the Protection of Human Subjects (Common Rule)

Regulations that govern research on human subjects.

Good Samaritan Statute

State law or statute that protects healthcare providers from liability for not obtaining informed consent before rendering care to adults or minors at the scene of an emergency or accident.

A competent adult's right to refuse consent to medical treatment applies even when the treatment is lifesaving. True or False?

True.

Battery is the usual basis of a claim for which an individual did not give consent for a procedure that was performed. True or False?

True.

General consent allows healthcare providers to provide routine noninvasive services. True or False?

True.

IRBs may waive the informed consent requirement for research that only involves retrospective records of patient records. True or False?

True.

In right-to-die cases, courts will balance an individual's right to self-determination against the interests of the state. True or False?

True.

Informed consent should include alternatives to the proposed treatment or procedure. True or False?

True.

So-called long consent forms are only associated with human subjects research. True or False?

True.

State laws generally allow minors to seeks medical treatment for sexually transmitted diseases without parental consent. True or False?

True.

The Patient Self-Determining Act requires hospitals that are Medicare providers to document in the health record whether an individual has an advance directive. True or False?

True.

The Uniform Anatomical Gift Act permits an anatomical gift by any person designated to make decisions about a decedent's remains, as long as no objections are known. True or False?

True.

The basis for a lack of informed consent claim is generally negligence. True or False?

True.

The law permits a presumption of consent during emergency situations. True or False?

True.

The use of short consent forms generally requires the signature of a witness to the explanation of risks, benefits, and alternatives. True or False?

True.

Unless it is designated as durable, a power of attorney is only effective when the principal has the capacity. True or False?

True.