- Joined
- Jan 6, 2019
This is a good question, and there’s no one answer, but in general, the patient should be deemed to have capacity to consent. That needs to be assessed, and it can vary in a single patient t over time and for different things.but that opens the door to the argument "How mentally stable does one have to be to be a properly consenting person?"
For example: someone with schizophrenia may be perfectly rational a lot of the time and be able to give consent for something. But if they’re at a point where they’re very unwell they may not be.
Example 2. Someone with, say, Down syndrome may be capable of consent for day to day medical treatment but incapable of deciding more serious or complex issues.
In trials, some patients are just blanket deemed to be vulnerable and while they must assent to the procedures they must also have a legally acceptable representative like a caretaker or guardian who must also consent. Both the assent and consent are required and the trial must still be explained to subject and caretake in acceptably and appropriate language.
Who’s vulnerable? Minors, always. Prisoners, wards of state or court, prisoners, (they are susceptible to coercion from the state) anyone with dementia, Parkinson’s and certain mental illness like schizophrenia, the mentally retarded. That’s not an exclusive list, anyone with reduced capacity mentally could be deemed incapable of consent.
Even regular joes can be - extreme fatigue or illness can also have you deemed incapable. I’ve no idea on the legal side past how to make what I do ethical, so I don’t know if it could be argued that a lot of these people were simply incapable of consent or not. BUT that is very clearly why the push for child consent and gillick competence is so strong. The lower that bar is the easier it is to get away with all this.