Consent and Capacity in Legislation

Consent

• Different Legislation
• Education Act: Parental consent is required for intellectual or personality assessments of children under 18.
• Child and Family Services Act: Children aged 12 or over, involved with Ministry of Community and Social Services, can consent to counselling services.
• Health Care Consent Act: Anyone "capable with respect to treatment" can consent to their own treatment; no minimum age is specified.
• Substitute Decisions Act (1992): Individuals 16 years or older are presumed capable of consenting to personal care. Practitioners can determine if a younger individual is capable, but greater care is required for such a determination.
• Capacity
• Factors to Consider:
  • Quality of the decision-making process
  • Context-dependent (capacity may fluctuate)
• Four Criteria for Assessing Capacity:
  • Understanding: Ability to comprehend information related to their condition, treatment options, risks, and benefits, including the choice of no treatment. This involves demonstrating comprehension, not just repeating information.
  • Appreciation: The ability to apply the information to their own situation. This may involve considering the potential consequences of their choices related to their condition and treatment.
  • Reasoning: Decisions made by the individual should reflect a logical reasoning process.
  • Expression of Choice: The communication of a clear and consistent decision that is expressed over time.

Definitions

• Appropriate Consent:
  • Consent must be related to the treatment, informed, voluntary, and not obtained through deception.
• Informed Consent:
  • Individuals must receive information about the nature of the treatment, expected benefits, risks, side effects, alternative options, and potential consequences of not receiving treatment.
  • Information should be provided in a way that is accessible to the individual's understanding, language skills, and needs.
• Treatment:
  • As defined by the Health Care Consent Act: Anything done for therapeutic, preventative, palliative, diagnostic, cosmetic, or health-related purposes. It does not include health history taking, assessments/examinations to determine general condition, treatments with minimal risk, or capacity assessments for treatment.
• Psychoeducational Assessments
  • Not considered “treatment” under the Health Care Consent Act and can be conducted without formal consent.

Age of Consent

• Adults are presumed capable of consenting to treatment.
• Capacity refers to the ability to make a particular decision at a particular time.
• Capacity can vary for different decisions within the same person and can fluctuate over time.
• Right to Refuse Treatment: Individuals with capacity have the right to refuse treatment.
• Duty of Care for Individuals Without Capacity: Practitioners have a duty to provide treatment and care in the best interests of individuals lacking capacity, even if they do not agree.

Rules of Thumb for Determining Capacity

• Responsibility for Assessment: Practitioners giving treatment are responsible for assessing a patient's capacity and seeking assistance if needed.
• Understanding is Key: Capacity depends on understanding, which is influenced by effective communication, accessible information, and cognitive abilities.
• Right to Information: Individuals lacking capacity have the right to receive information.
• Invalid Consent: Consent obtained through coercion is not valid.
• Behavioral Indicators: Consent can be demonstrated through behavior.

Confidentiality and Privacy

• Limits of Confidentiality:
• Practitioners must inform clients of the limits of confidentiality during or before service provision.
• Applicable Privacy Legislation:
• The Personal Health Information Protection Act (2004) usually applies.
• Practitioners are responsible for ensuring client access to their personal or health information unless prohibited by law.
• Information about Third Parties:
• Information about third parties may only be disclosed with consent, as required by law, or when legally permitted.
• Access by Client or Client's Representative:
• Practitioners must provide clients, and their authorized representatives, with access to their information, unless legally prohibited or otherwise permitted to refuse access.
• Test Security:
• Practitioners must respect test security and copyright restrictions.
• Test materials and proprietary information should not be shared without permission.
• Practitioners should obtain the permission of publishers for releasing proprietary information and may need to provide transcribed responses to tests without revealing test questions or proprietary information.

PHIPA (Personal Health Information Protection Act) Obligations

• Consent for Collection, Use, and Disclosure: Obtain consent for collecting, using, or disclosing personal health information (PHI).
• Data Security: Maintain the security of PHI by taking reasonable precautions against theft, loss, unauthorized use or disclosure.
• Accuracy: Ensure the accuracy of PHI.
• Minimize Collection: Collect, use, or disclose only necessary PHI.
• Access Rights: Provide individuals with access to their PHI upon request (with exceptions for legal proceedings or situations where access poses a risk of serious harm).
• Corrections: Correct incomplete or inaccurate PHI upon request.

Explore the various legislative frameworks regarding consent and capacity, particularly focusing on the Education Act, Child and Family Services Act, and Health Care Consent Act. This quiz delves into the age requirements and assessment criteria needed for individuals to provide consent for treatment and services.