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  • Consent: 1) can be written, verbal, implied (by actions) or waived 2) informed, voluntary, truthful
  • Information for consent
    • Risk
      • Professional standard (same sort that other doctors would give - old system)
      • Reasonable person standard (newer system - now invalid)
      • Subjective person standard (Rogers and Whittaker case - current system)
        • You need to give a level of information that is tailored to the person with their own life circumstances
        • Talk about risks and harms particular to your own patient'
  • Understanding
    • Affected by how you present it, time and place you choose (you need a quiet room where they can concentrate), the relationship the person has with the doctor (are they comfortable enough to say they don't understand?)
  • Competence
    • Affected by age (young/old; but don't assume. Age of competence: emerging from 14-16), mental illness
    • Drugs, alcohol, injury, disease
  • Voluntary
    • Has to reflect their own personality, and not be induced by your own ideas
  • Doctors don't need to get consent in justified paternalism:
  1. Person is not competent
  2. Acting to prevent harm
  3. Can presume that when the person regains consciousness, they will ratify the decision
  4. Waiver
  5. Adolescence/children
  • Informed consent
    • Contains a number of elements
    • Principle of autonomy
    • Competent patient
    • Non-manipulative
    • Full disclosure
  • Consent is about trust, communication and how you give information to your patient
  • Standards of consent
    • NHMRC: material risks
    • patient centred
    • reasonable person standard
  • Deontology - butt out of their life unless you harm other people or you undermine the fabric of society
  • Utilitarianism - greatest good for the greatest number, end justifies the means