Scott Lamont

MN (Hons) candidate

Capacity assessment and its relationship to consent to treatment in the general hospital setting

Supervisors: Yun-Hee Jeon and Mary Chiarella


Introduction

Mental capacity has been researched from within the disciplines of bioethics, medicine and law, and the field of capacity assessment is dominated by tension between the principles of autonomy (self determination) and beneficence (protection). It has been proposed that postgraduate education and training within medicine has neglected the areas of ethical, professional and legal obligations in relation to consent within clinical practice. However, these responsibilities are arguably not exclusive to medicine and are the concern of all Health Care Professionals (HCPs) delivering interventions. Mental capacity has been argued to be the key component of consent to treatment, and its link to autonomy has emerged as a central component of health care law.
Inadequate attention to ethical, professional and legal obligations with regards to capacity or consent to treatment within generalist health care could lead to claims of human rights infringements. These infringements could also result in actions of battery and false imprisonment, negligence and subsequent malpractice suits, and potential awards of damages, loss of employment or professional body deregulation. These infringements are highlighted when issues of capacity are not recognised or poorly understood.

Aim

This study aims to examine through an integrative review the processes involved in the assessment of patients’ capacity to consent to or refuse treatment within the adult general hospital setting.

Methodology

This integrative review will investigate what is known about Health Care Professionals’ (HCPs) knowledge, attitudes and behaviours related to these processes and the instruments used in the assessment of these processes. An integrative review was chosen because of the various research designs and methods within the retrieved studies.

Significance

This study is significant in examining the potential for human rights, statutory and civil law infringements with regards to capacity and consent processes within Australian health care. An understanding of the knowledge, attitudes and behaviours of general hospital HCPs in relation to capacity and consent is essential in identifying potential knowledge gaps and attitudinal or behavioural dispositions which may influence compliance with statute, common law and health related policy. Attention to these issues will benefit not only patients in the preservation of their rights, but also HCPs and health care authorities in minimising potential claims of infringement and litigation. Increased knowledge of these issues will also help inform future policy review and development processes within local, state and national health care forums. There is currently no published literature within Australia reporting organisational efforts to engage this issue.