Emergency surgery on mentally impaired patients: standard in consenting

Authors

Mihai Paduraru, Milton Keynes University Hospital NHS Foundation Trust, Emergency Surgery Department, Milton Keynes, UKFollow
Ahmed Saad, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, UKFollow
Krystian Pawelec, Milton Keynes University Hospital NHS Foundation Trust, Emergency Surgery Department, Milton Keynes, UKFollow

Abstract

Emergency surgery is often performed on the elderly and susceptible patients with significant comorbidities; as a consequence, the risk of death or severe complications are high. Consent for surgery is a fundamental part of medical practice, in line with legal obligations and ethical principles. Obtaining consent for emergency services (for surgical patients with chronic or acute mental incapacity, due to surgical pathology) is particularly challenging, and meeting the standards requires an up-to-date understanding of legislation, professional body guidelines, and ethical or cultural aspects. The guidance related to consent requires physicians and other medical staff to work with patients according to the process of ‘supported decision-making’. Despite principles and guidelines that have been exhaustively established, the system is sometimes vulnerable in actual clinical practice. The combination of an ‘emergency’ setting and a patient without mental ‘capacity’ is a challenge between patient-centered and ‘paternalistic’ approaches, involving legislation and guidelines on ‘best interests’ of the patient.

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Recommended Citation

Paduraru, Mihai; Saad, Ahmed; and Pawelec, Krystian (2018) "Emergency surgery on mentally impaired patients: standard in consenting," Journal of Mind and Medical Sciences: Vol. 5: Iss. 1, Article 4.
DOI: https://doi.org/10.22543/7674.51.P1620
Available at: https://scholar.valpo.edu/jmms/vol5/iss1/4