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080917L - ETHICO-LEGAL ISSUES IN MEDICAL DECISIONS FOR INCOMPETENT ADULTS

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Background material by Professor Omar Hasan Kasule for Year 2 Semester 1 Med PPSD session on 17th September 2008.


TREATMENT OF ADULTS WITHOUT CONSENT
1.      Describe the basis for a physician treating an incompetent patient without consent (best interests /benefit of the patient, necessity).
2.      Describe situations in which physicians can treat patients without consent (emergencies, compulsory treatment of mental patients).
3.      Describe legal guidelines of consent for preventive procedures (screening, immunization).
4.      Describe 2 considerations in detaining or restraining patient movements (freedom to move, protection of the patient and others from harm).
5.      Describe the main provisions of the mental health act regarding treatment of mental patients and describe the committal procedure.


PROCESSES OF CONSENT FOR INCOMPETENT ADULTS:
6.      Describe the involvement / role of the family in the consent process for the incompetent
7.      Describe 2 ways in which a proxy decision maker can reach a decision (preferences of the patient, best interests of the patient).
8.      Explain how an advance statement is a form of prospective autonomy.
9.      Describe disadvantages of advance statements
10. Describe the format of an advance statement.
11.  List conditions in which a physician must seek a second opinion or court review if the patient in incapacitous (detention and restraint, sterilization or impairing fertility, pregnancy termination, withdrawing or withholding artificial nutrition and hydration, organ donation).