Informed Consent for Healthcare Decisions医疗知情同意的决定.ppt

INFORMED CONSENT for HEALTHCARE DECISIONS OBJECTIVES Recognize the importance of self-determination in healthcare services Understand the related legal issues Identify the elements of true informed consent Identify the legal hierarchy for medical consent Be prepared to support people in taking charge of their healthcare decision-making process Consider your own personal plan CONSENT ISSUES Study by U.S. Surgeon General: People with DD have more medical conditions, yet are more often poorly diagnosed... over/under treated Consent often leads to better care SELF-DETERMINATION Ability of people to: Control their lives Reach goals they have set Take part fully in their community Capacity depends on real ability May necessitate teaching support to maximize according to potential BASIC LEGAL PRINCIPLES Every person has right to make healthcare decisions unless determined otherwise Non-emergency healthcare requires informed consent Family/friends preferable to public agencies as substitute decision makers Options that place fewest limits on individual’s decision making are preferred Decision-making laws are state specific INDEPENDENT DECISION MAKING - ADULTS Presumed unless proven otherwise OR court appointed guardian Determined by actual functioning in specific context (not dx) Understands basic risks benefits; can communicate decision Decision is clearly voluntary (not coerced) No formal assessment is required Competence can change over time Health-General 5-601 – guides the physician: “Incapable of making an informed decision means...inability ...because the patient is unable to understand the nature, extent, or probable consequences of...treatment; unable to make a rational evaluation of the burdens, risks, and benefits of the treatment...or is unable to communicate a decision” (speech not required) INFORMED CONSENT Three elements: Information Understanding Choice Assistance can be provided to help individual make the decision Ability to make decisions based on co