Aust Fam Physician
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Doctors must generally obtain a patient's consent for a medical procedure before it is undertaken. When a patient has impaired mental capacity, the doctor may be uncertain whether the patient is competent to consent and decide that consent must be obtained from someone else. recent legislation gives legal authority to people appointed by the patient, or by the state; or a relative or carer, to consent (or refuse) on behalf of the patient. ⋯ This paper explains the general legal requirements to obtain consent; a how a patient's competence is assessed; and the people who may legally consent (or refuse) on behalf of an incompetent patient. A case study illustrates how the legal principles are applied in practice.
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Randomized Controlled Trial Clinical Trial
Communication across the divide. A trial of structured communication between general practice and emergency departments.
To evaluate the impact of structured form letters for general practitioner to emergency department (ED) communication. ⋯ This study demonstrates that improvements to communication between GPs and EDs are difficult and may require a systemic change within general practice and the hospital. Electronic systems may allow the sort of reciprocal communication required to establish and sustain improvement.
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'Advance directives' are instructions given by an individual regarding future health care decisions should they become incapacitated. ⋯ General practitioners require time and information if they are to assist patients in the process of completing an advance directive. Further research and extensive public education are necessary to develop relevant strategies to encourage the use of advance directives if they are to be utilised to assist people to face death with some sense of control.