Geriatric Quick Consult       Decision-making Capacity      DOs and DON'Ts

Decision-making Capacity: Informed Consent

In theory, any treatment, even giving a Tylenol tablet, involves patient consent. However, we assign greater importance to some decisions, and require documented, informed consent. These include certain blood tests (e.g.: HIV antibody), blood transfusions, and most invasive procedures. This section of GQC covers approaches to providing high quality informed consent when working with elderly patients. Follow these DOs and DONTs and you’re on your way.


DO all of these DON'T do any of these
Assess the patient’s ability to make informed decisions for themselves accept consent from patients that have impaired decision-making capacity
Evaluate the patient when the patient is at their best (may require multiple tries) impose your values on patients or families
When unsure, request another qualified professional’s opinion hurry the consent process
Always involve the family, even when the patient’s thoughts are clear mislead patients or families about risk or benefit
Respect patient autonomy and freedom of choice seek consent at times when patients are confused or lethargic
Explain the procedure in terms that the patient and family can understand confuse decisional capacity with "competence" which is determined by a judge
Involve a witness, whether in person or on the telephone make the consent process unnecessarily complicated
Document the consent assume that decisional capacity requires “normal” thought processes
When patients are incapacitated, contact the appropriate surrogate decision-maker  


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