Adult Medical Emergency Handbook - Scottish Intensive Care Society

casenotes. Always discuss with next of kin.
• Incapacity: e-version.
• Diagnosis: review the evidence. The diagnostic “label” may
be inaccurate or incomplete. Don’t make assumptions and
“don’t give up the search” for alternative explanations for the
patient’s presentation especially if there is poor response to initial
treatment.
ADULTS WITH INCAPACITY ACT
General Principles
• Under the Act an adult is defined as a person who has attained 16
years of age.
• All adults are considered capable of making their own medical
decisions unless proven otherwise.
• Without consent for any procedure or treatment the health care
professional carrying out the procedure or treatment could be
liable for assault.
• It is the doctor primarily responsible for the patient’s medical
treatment who is responsible for assessing the patient’s capacity
to consent to treatment.
Legal capacity requires that an individual be capable of:
• understanding why treatment or a procedure is necessary.
• retaining information given before making a decision.
• being able to communicate a decision.
• understanding implications of refusing or allowing treatment and
being able to retain this information.
Incapacity may be short lived e.g. acute confusional state or more
longstanding e.g. dementia.
MEDICAL TREATMENT
Medical treatment is defined as:
• ‘any treatment that is designed to promote or safeguard physical
or mental health’.
The treatment must be clinically indicated and must:
• promote or safeguard physical or mental health.
• take account of present and past wishes e.g. advance directive or
living will.
• take account of the views of any relevant others including health
care professionals involved in the patient’s care, relatives or carers
adult medical emergencies handbook | NHS LOTHIAN: UNIVERSITY HOSPITALS DIVISION | 2009/11
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