LWS101 Chap.5 Adults: Consent and Refusal of Treatment
Adults: Consent and Refusal of Treatment
Consent and autonomy
Treatment without consent or another lawful justification risks liability for assault.
A capable adult may refuse any treatment, and capacity is presumed, judged for the particular decision and the time it is made.
When capacity is lost
An advance health directive made while capable guides care; without one, a substitute decision-maker decides, applying Queensland's general principles and health care principles under sections 11B and 11C of the Guardianship and Administration Act 2000.
Three questions to ask every time
Most Week 5 scenarios can be unlocked with three questions in order.
Does this adult have capacity for this decision now? If not, is there an advance health directive that covers it? If not, who is the lawful substitute decision-maker, and what do the principles require them to weigh? Answering them in that order keeps your law heading logical and stops you skipping straight to family members.
What this chapter covers
- 01
Consent and Assault
- 02
Elements of Valid Consent
- 03
Presumption of Capacity
- 04
Refusal of Treatment
- 05
Advance Health Directives
- 06
General and Health Care Principles
Worked example · free
Is a signed form a valid consent?
- 1Informed consent requires knowledge and understanding of the benefits and risks; she misunderstood the procedure.
- 1Principle 2.3 requires information in a language the person understands, using interpreters when necessary.
- 1A signature does not cure the missing understanding, so consent was likely not valid.
Key terms
- Capacity
- The ability to make and communicate a decision about a particular matter at a particular time.
- Statutory Health Attorney
- A person who may make health decisions for an adult with impaired capacity under Queensland's guardianship framework.
- Substituted Judgement
- The health care principle of deciding as the adult would likely have decided, based on views expressed while capable.
- Structured Decision-Making
- The four-step general principle that starts with supporting the adult's own decision before anyone decides for them.
- Least Restrictive Option
- The requirement that powers are exercised in the way that least restricts the adult's rights and opportunities.
- Guardianship Framework
- Queensland's system of laws and principles for making decisions on behalf of adults with impaired capacity.
- Assault
- In this topic, treating a person without consent or another legal basis, which exposes the practitioner to liability.
Adults: Consent and Refusal of Treatment FAQ
Can a competent adult refuse life-saving treatment?
Yes. The withholding-treatment overview states that adults with capacity may refuse any treatment, even when it is needed to keep them alive, and that autonomy overrides the sanctity of life in that situation. Treating them against a capable refusal risks liability for assault.
Does a diagnosis such as dementia mean a patient lacks capacity?
Not by itself. Every adult is presumed to have capacity until shown otherwise, and capacity is specific to the decision and the time it is made. A person with dementia may be able to make some decisions and not others, so the nurse must assess the particular decision.
What must a substitute decision-maker consider?
Both sets of Queensland principles bind them, general and health care alike, covering the adult's views and wishes, the information from the health provider, the condition and prognosis, alternatives and risks, whether the care could be postponed, and the effect on the adult's dignity and autonomy.
Can a patient change their mind after signing a consent form?
Yes. Consent is an ongoing agreement rather than a single signature, and Principle 2.3 asks nurses to give people time to ask questions, make decisions and refuse care, and to proceed according to the person's choice. A capable patient who withdraws consent before a procedure should have that decision respected and recorded.
Exam move
Learn the capacity route as a flow you can sketch in twenty seconds: capacity for this decision, then directive, then substitute. Practise writing the presumption of capacity as the first sentence of every Week 5 law heading.
Read the general and health care principles factsheet once with a highlighter and summarise each principle in five words, because quoting the right one is quicker than paraphrasing the whole list in the exam. Before the exam, rehearse the three capacity questions until you can write them in under a minute.
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