10 •


Advice


CONSENT WITHOUT CAPACITY


Informed consent is vital for all dental treatment. But who consents for patients


who are not competent? MDDUS dental adviser Doug Hamilton offers some guidance


consent is contingent upon the competence of the person providing it. So if your patient is not competent to consent to treatment – what should you do?


B


Informed consent It is helpful to first look at the basics of consent that apply to all patients. Dentists must explain the risks associated with any proposed treatment, as well as the costs, alternatives and the potential consequences of non-treatment. All of this should be done in a setting and manner that makes it easy to make an informed and independent decision. And if the patient is capable of understanding, retaining


or weighing up appropriately worded information, then you must respect their decision – even if they refuse to give consent. Remember, however, that just because competent


patients have the right to refuse some or all proposed treatment does not mean they can demand treatment which is contrary to the clinician’s best judgement. Beware of overbearing patients who try to persuade you to start ill- advised treatment, regardless of whether they offer assurances such as: “Don’t worry- I’ll sign something before we start”. That way lies madness! Even the most beautifully constructed consent document does not validate a harmful intervention. The issue of consent in incompetent adults is governed by separate legislation in Scotland and in England and Wales.


EFORE beginning any course of dental treatment with a patient, you must first get their consent. It’s a fundamental legal and ethical requirement for dentists and our training carefully spells out the steps that must be followed to achieve it. But the validity of this


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16