Consent for Anaesthesia - aagbi

More documents

Recommendations

Info

Section 2IntroductionThe Association of Anaesthetists of Great Britain and Ireland firstformally addressed the issue of consent in 1999, establishing aWorking Party chaired by Professor Alan Aitkenhead. The fruits of theirlabours – ‘Information and Consent for Anaesthesia’ – clearlyexplained the ethical, professional and legal responsibilities ofanaesthetists with respect to providing information and seekingconsent. The current Working Party has drawn considerably from thisadvice and is happy to acknowledge those who contributed to it.In recent years, several developments have prompted the Associationto revisit the question of consent. On the legal front, the introductionof the Mental Capacity Act 2005 in England and Wales – preceded bythe Scottish Adults with Incapacity Act 2000 – has finally given a voiceto adults without capacity to consent, and has imposed a series ofduties upon clinicians to promote capacity. It has also formalised theAdvance Decision (formerly Advance Directive) and extended Powersof Attorney to include medical decision-making. This alone wasenough to justify the Association producing new advice, but perhapsof more impact to the ‘ordinary’ patient-doctor interaction is theincreased emphasis placed by the courts on patient’s autonomy,crystallised in the House of Lords judgment in Chester v Afshar in 2004[1].As well as addressing these issues, the Working Party has expanded theoriginal document to take in views on consent with relation to chronicpain procedures and critical care. Increasing litigation and theinfluence of organisations like the Clinical Negligence Scheme forTrusts, the Healthcare Commission, the National Patient Safety Agencyand the General Medical Council have caused the Working Party toexamine carefully the amount of information that should be providedto patients and the way in which this provision, and the ensuingdiscussion about care options, should be documented in the patient‘srecord. Finally, and in keeping with the ethical emphasis of thisdocument, we have considered in more detail the obligations of theclinician who allows others to hone their practical skills on a patient.4
Although there is much in this document that may seem novel or evencontentious, the ‘take-home messages’ remain unchanged at the heartof professional practice: we must allow our patients to make their owndecisions about their care in full possession of the relevantinformation; good communication makes for good medicine; andgood records are essential for the defence of the doctor.David BogodDecember 20055
Page 1 and 2: Consent for AnaesthesiaRevised Edit
Page 3 and 4: CONTENTSSection 1 Recommendations 2
Page 5: • The MCA places a duty upon care
Page 9 and 10: patient, who has the capacity (comp
Page 11 and 12: of an incapable adult patient [14].
Page 13 and 14: another, but the imbalance of power
Page 15 and 16: 5.3.2 Written information should be
Page 17 and 18: in written information, as should t
Page 19 and 20: 6.4 Documentation is particularly i
Page 21 and 22: Section 8Advance Decisions (‘adva
Page 23 and 24: such a degree that the ability to d
Page 25 and 26: 9.3.2 In England and Wales, 16 and
Page 27 and 28: antenatal advice for women concerni
Page 29 and 30: Section 10 Research, audit and trai
Page 31 and 32: competence before the patient’s s
Page 33 and 34: 16. Department for Constitutional A

Consent for Anaesthesia - aagbi

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?