Literature Review on Provision of Appropriate and Accessible ...

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PAGE 238 Capacity A patient will lack capacity to consent to a particular intervention if he or she is: • unable <strong>Literature</strong> to comprehend <strong>Review</strong> on and Provision retain of information Appropriate material and Accessible to the Support to People with an Intellectual Disability who are decision, especially as to the consequences of having, or not Experiencing Crisis Pregnancy having, the intervention in question; and/or • unable to use and weigh this information in the decision-making process. Before making a judgement that a patient lacks capacity you must take all steps reasonable in the circumstances to assist the patient in taking their own decisions (this will clearly not apply if the patient is unconscious). This may involve explaining what is involved in very simple language, using pictures and communication and decision-aids as appropriate. People close to the patient (spouse/partner, family, friends and carers) may often be able to help, as may specialist colleagues such as speech and language therapists or learning disability teams, and independent advocates or supporters. Capacity is ‘decision-specific’: a patient may lack capacity to take a particular complex decision, but be quite able to take other more straight-forward decisions or parts of decisions. Best interests A patient’s best interests are not limited to their best medical interests. Other factors which form part of the best interests decision include: • the wishes and beliefs of the patient when competent • their current wishes • their general well-being • their spiritual and religious welfare. Two incapacitated patients, whose physical condition is identical, may therefore have different best interests. Unless the patient has clearly indicated that particular individuals should not be involved in their care, or unless the urgency of their situation prevents it, you should attempt to
PAGE 239 involve people close to the patient (spouse/partner, family and friends, carer, supporter or advocate) in the decision-making process. Those close to the patient cannot require you to provide particular treatment which you do not believe to be clinically appropriate. However they will know the patient much better than you do, and therefore are likely to be able to provide valuable information about the patient’s wishes and values. Support to People with an Intellectual Disability who are Accessible and Appropriate of Provision on <strong>Review</strong> <strong>Literature</strong> Experiencing Crisis Pregnancy Second opinions and court involvement Where treatment is complex and/or people close to the patient express doubts about the proposed treatment, a second opinion should be sought, unless the urgency of the patient’s condition prevents this. Donation of regenerative tissue such as bone marrow, sterilisation for contraceptive purposes and withdrawal of artificial nutrition or hydration from a patient in PVS must never be undertaken without prior High Court approval. High Court approval can also be sought where there are doubts about the patient’s capacity or best interests.
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Literature <strong
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Literature <strong
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PAGE 5 Foreword by the HSE Crisis P
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PAGE 7 Foreword by the National Dis
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PAGE 9 About the author Joan O’Co
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PAGE 11 2.5.4 Codes of practice 52
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PAGE 13 4.5.1 Challenges in support
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PAGE 15 Glossary of terms Enduring
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PAGE 17 • The pattern of contrace
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PAGE 19 • The review considers th
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PAGE 21 • To describe the challen
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PAGE 23 on how impairments affect f
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PAGE 25 • Searches by publication
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PAGE 27 • Differences in definiti
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PAGE 29 • 32 per cent (8,262 indi
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PAGE 31 1.7 Heterogeneity People wi
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PAGE 33 McCarthy (1999: 44) notes t
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PAGE 35 partner was the same age, a
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PAGE 37 1.10 Structure of the revie
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PAGE 39 is placed on their health a
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PAGE 41 McCarthy (1999: 221), who c
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PAGE 43 • Contraception in women
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PAGE 45 Wehmeyer and Bolding’s re
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PAGE 47 persons who lack decision-m
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PAGE 49 • Consent and capacity in
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PAGE 51 2. When doing the act, reas
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PAGE 53 2.6 Critique of the Law Ref
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PAGE 55 or she is unable to make a
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PAGE 57 Good practice provisions of
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PAGE 59 reasonably can to work out
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PAGE 61 has reasonable grounds to b
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PAGE 63 They point out that evaluat
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PAGE 65 2.8.2 Assessment of capacit
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PAGE 67 In the absence of explicit
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PAGE 69 4. Physical disabilities, n
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PAGE 71 The British Medical Associa
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PAGE 73 legislation in this area an
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PAGE 75 • Consideration of whethe
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PAGE 77 perceive sexual activity as
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PAGE 79 The right to have children
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PAGE 81 • In relation to capacity
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PAGE 83 more serious the decision,
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PAGE 85 - The requirement that the
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PAGE 87 3.0 Capacity to consent to
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PAGE 89 The following rights, oblig
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PAGE 91 relationships of various ki
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PAGE 93 Studies consistently show t
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PAGE 95 Functional approach is base
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PAGE 97 • There needs to be a rea
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PAGE 99 of capacity to consent to s
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PAGE 101 Meanwhile, the authors fou
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PAGE 103 3.8 Situational aspect of
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PAGE 105 3.11 Laws that prohibit se
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PAGE 107 autonomy and fulfilment. I
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PAGE 109 laws generally require tha
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PAGE 111 • Offences where the def
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PAGE 113 2002; McCabe, 1999). Grayd
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PAGE 115 higher prosecution rates.
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PAGE 117 Section 17 of the Crimes (
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PAGE 119 relationships. The study i
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PAGE 121 Table 3: Comparative legis
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PAGE 123 Legal aspect Ireland Unite
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PAGE 125 Legal aspect Relevant legi
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PAGE 127 any formal contract or tes
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PAGE 129 Laws that prohibit sex wit
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PAGE 131 and the particular pressur
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PAGE 133 relationships, marriage, a
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PAGE 135 • 44 per cent knew that
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PAGE 137 be perceived as a risk fac
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PAGE 139 4.3.1 Components of sex ed
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PAGE 141 introduced students not on
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PAGE 143 to have a significant impa
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PAGE 145 about pregnancy and childb
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PAGE 147 Eastgate (2008), writing i
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PAGE 149 • Considered themselves
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PAGE 151 4.7 Pregnancy outcomes in
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PAGE 153 The authors suggested that
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PAGE 155 Research indicates that le
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PAGE 157 Klaar (1999) notes that so
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PAGE 159 Workers might also need to
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PAGE 161 • Possible components of
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PAGE 163 Accessing services • The
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PAGE 165 5.0 Parenting 5.1 Introduc
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PAGE 167 5.2 Approaches to understa
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PAGE 169 fulfilling three condition
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PAGE 171 Tarleton et al.’s study
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PAGE 173 vulnerable if a breakdown
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PAGE 175 More recent research on mo
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PAGE 177 while training programmes
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PAGE 179 5.8 Adequacy of training a
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PAGE 181 5.10 Key findings Key find
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PAGE 183 Professional and training
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Support to People with an Intellect
Page 187 and 188: PAGE 187 The review examined nation
Page 189 and 190: PAGE 189 A number of issues have be
Page 191 and 192: PAGE 191 6.5 Capacity to consent to
Page 193 and 194: PAGE 193 • A number of commentato
Page 195 and 196: PAGE 195 • During the early stage
Page 197 and 198: PAGE 197 Bibliography Affleck, F. (
Page 199 and 200: PAGE 199 Bartlett, P. (2008) Blacks
Page 201 and 202: PAGE 201 Booth, T. & Booth, W. (200
Page 203 and 204: PAGE 203 Burgen, B. (2008a) ‘Stra
Page 205 and 206: PAGE 205 Cuskelly, M. & Bryde, R. (
Page 207 and 208: PAGE 207 Issues in Sexuality and Le
Page 209 and 210: PAGE 209 The Mental Health Foundati
Page 211 and 212: PAGE 211 Gust, D.A., Wang, S.A., Gr
Page 213 and 214: PAGE 213 Kaplan C. & Richman S. (20
Page 215 and 216: PAGE 215 Leutar, Z. & Mihokovic, M
Page 217 and 218: PAGE 217 Mayes, R., Llewellyn, G. &
Page 219 and 220: PAGE 219 McConnell, D., Llewellyn,
Page 221 and 222: PAGE 221 Murphy, G.H. & Clare, I.C.
Page 223 and 224: PAGE 223 O’Hara, J. & Sperlinger,
Page 225 and 226: PAGE 225 Rogers, J. (1997) Birthcoa
Page 227 and 228: PAGE 227 period 1988 to 1999. Journ
Page 229 and 230: PAGE 229 Traustadottir, R. (1997) W
Page 231 and 232: PAGE 231 Watson, G. & Rogers, R. (1
Page 233 and 234: PAGE 233 Appendices Appendix A - Co
Page 235 and 236: PAGE 235 Form 4 D Involvement of th
Page 237: PAGE 237 Guidance to health profess
Page 241 and 242: Experiencing Crisis Pregnancy <stro
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