Page 104 - Registrar Orientation Manual 2016

Document reference:
1969
Effective date:
30 Mar 2010
Expiry date:
01 Jun 2013
Page:
12 of 24
Title:
Informed consent
Type:
Policy
Version:
03
Authorising initials:
5.3. When the patient is not competent
medication, and the procedure is not urgent, recovery should be allowed before consent to further treatment is sought.
Only certain people can consent to medical treatment on behalf of an incompetent patient.
 In the case of children, S36 of Care of Children Act 2004 applies.
Consent may be given by:
- a parent or legal guardian
or if no such person is available
- "by a person in New Zealand who has been acting in the place of
a parent"
or if neither of the above can be satisfied, then
- by a District Court Judge or the Chief Executive of Social Welfare.
 In the case of adults (18 years and over), the provisions of the Protection of Personal and Property Rights Act 1988 may apply. This legislation provides for the appointment of welfare guardians and for the granting of enduring powers of attorney. In brief: a welfare guardian appointment is made by the Court on behalf of a person who is unable to appoint someone to look after their affairs; enduring power of attorney is granted by someone (“the donor”) to another person (“the attorney”) to enable the attorney to look after the donor’s affairs when they become incompetent. It is important to confirm that the nature and extent of the welfare guardianship or power of attorney includes health care decisions. This can only be done by sighting the Court Order appointing a welfare guardian, a copy of which needs to be placed in the patient’s clinical notes
 Neither the patient's next of kin nor any other relative has the right to consent or refuse medical treatment on the patient's behalf unless they are a welfare guardian, or hold an enduring power of attorney in relation to personal care and welfare.
 No welfare guardian or person with enduring power of attorney has the legal right to consent on behalf of the patient to:
- the administration of electro-convulsive treatment or
- the performance of brain surgery designed to destroy any part of
the brain or any brain function or
- the patient taking part in any medical experiment (except for the
purpose of saving the patient’s life or preventing serious damage to the patient’s health)
 No welfare guardian or person with enduring power of attorney can refuse to consent to the provision of any standard medical treatment or procedure intended to save the patient’s life or prevent serious damage to their health.
 No legal representative has the right to consent to the patient’s sterilisation if the patient is incompetent only by reason of their age.