Sangeetha Pradeep Paediatric Consultant Broomfield Hospital Overview What is a consent When is the consent needed Can children consent for themselves Who can get consent Who can give the consent ID: 1010709
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1. Consent & Capacityin PaediatricsSangeetha PradeepPaediatric ConsultantBroomfield Hospital
2. OverviewWhat is a consent?When is the consent needed?Can children consent for themselves?Who can get consent?Who can give the consent?What if a parent refuses to give the consentWhat is capacity?How is the capacity assessed?What if no capacity to consent?Determining best interestsCapacity can changeExamples
3. What is a consentUnderstand what’s going on with youGood things (benefits)/ Bad things (risks)Consent- Agree, say yes to
4. When is the consent neededImplied consentVerbal consentWritten consent- accompanied by information formCon sent should be voluntary
5. Can Children consent for themselves?Legal age for a childCan 16year old Consent?What if 16year old refuses to consent?Competent young childWhat if competent young child refuses?Can parents over-ride- over 16/ Under 16
6. Who can get consent?Ideally- person doing the procedureCapable of performing procedureSpecially trained to seek consent for the procedure
7. Who can give the consent The childThe child's mother or father The child's legally appointed guardian A person with a residence order concerning the child Local authority designated to care for the child A local authority or person with an emergency protection order for the child
8. What if a parent refuses to give the consent?Decision can be overruled by the courtsBy law, only need 1 person with parental responsibility to give consent.In an emergency, treatment can proceed without consent.
9. What is capacity?Capacity means the ability to use and understand information to make a decision, and communicate any decision made.A person lacks capacity if their mind is impaired or disturbed in some way, which means they're unable to make a decision at that time.Examples- Neurological damage/ mental health disorder
10. How capacity is assessedThis will usually be done by an appropriately trained and experienced healthcare professional who's either: (recommending the treatment or investigation involved in carrying it out )decision will be accepted, even if one lose capacity at a later stage.
11. What if no capacity to consent?Seek family member/ person appointed by the individual when he/she had the capacity.Parental consent to be sought, if parents refusing, consider best interests, approach court if needed.
12. DETERMINING BEST INTERESTSconsidering whether it's safe to wait involving the person in decision as much as possible include religious or moral beliefs
13. Capacity can changeA person's capacity to consent can change. People can be considered capable of deciding some aspects of their treatment but not others. Example: a person with severe learning difficultiesSome people with certain health conditions may have periods when they're capable and periods when they're incapable. Example: a person with schizophrenia
14. Examples16 year old refusing blood transfusion (treatment planned because Hb- is 6g/dl), jehovah’s witness16 year old refusing blood transfusion (treatment planned because RTA, blood loss), jehovah’s witness12 year old – moderate to severe dehydration, refusing iv fluids16 year old with severe cerebral palsy- refusing for PEG change12 year old with Anorexia, refusing to eat
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