Page 101 - Registrar Orientation Manual 2016

Document reference:
1969
Effective date:
30 Mar 2010
Expiry date:
01 Jun 2013
Page:
9 of 24
Title:
Informed consent
Type:
Policy
Version:
03
Authorising initials:
Patient
Competent
Incompetent
Under 18
 Patient can consent to
their own treatment
 Legal guardian (usually a parent)
18 years and over
 Patient can consent to
their own treatment
 Welfare guardian or
 Attorney appointed under
an Enduring Power of
Attorney or
 Advance Directive or
 Healthcare provider
following Right 7(4) of the Code of Rights
 Right 7(2) of the Code of Rights states: ‘Every consumer must be presumed competent to make an informed choice and give informed consent, unless there are reasonable grounds for believing that the consumer is not competent.’
 The patient’s competence may be affected by medication, inebriation from drugs, alcohol or substance abuse, physical injuries, mental illness, or intellectual disability.
 Competence to consent shall be assessed by clinical evaluation and judgement. The treating health professional or delegate shall determine the degree to which the patient is able to:
- Understand the essential information to allow him/her to make an informed choice;
- retain that information and be able to recall it;
- use and weigh this information in the reasoning and decision-
making process;
- communicate their understanding and that they reached a decision
as a result of it.
 In determining competence, the focus must remain on the patient’s capacity to understand and communicate this effectively. If it is clear that the patient is competent in this regard, then the conclusion they reach must be respected. This is the case even if the health professional believes that the decision that they have made is not in the best interests of the patient. In addition to the factual information provided about their condition, the patient may choose to take additional personal factors into consideration.
 Competence shall be assessed in relation to the patient’s ability to make an informed choice and give informed consent to a particular service. (Some patients may not be competent to make a decision about some services but may be perfectly competent to give informed consent to a less complex service.)
 A patient who has diminished competence retains the right to make informed choices and give informed consent, to the extent that they are