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Consent to medical treatment 

 

Adults with Incapacity (Scotland) Act 2000 S48 and Section 50 requests

 AR-09-10-Table45

Why we are interested

We have a responsibility under the Adults with Incapacity Act (Scotland) 2000 to provide second medical opinions from nominated medical practitioners for treatments that are not covered by the general authority to treat (Section 47). The specific treatments are noted above. In addition, where there is a welfare proxy, such as a guardian or welfare power of attorney with the power to consent to medical treatment, and there is disagreement between them and the treating doctor, we have to provide a second opinion doctor to resolve the dispute.

What we found

There were 41 requests under Section 48 and 2 under Section 50. Of the 20 requests for electro-convulsive therapy (ECT), three people accounted for eight of these requests. For authority to treat under Section 48 in respect of ECT the patient must not be resisting, as well as being incapable of giving informed consent. Authority to treat was refused on four occasions, on two of these occasions treatment was subsequently carried out under the Mental Health (Care & Treatment) Act 2003, as it was refused on grounds that the person was resisting.

For treatment under Section 48a- medication to reduce sex drive, there were 20 requests and authority to treat was refused on 1 occasion.

Although consent to abortion was given under Section 48c, in fact the procedure was not carried out and the pregnancy continued to term.

The two instances where there was disagreement regarding the proposed medical treatment involved the decision to introduce a PEG tube to facilitate feeding. In both occasions, authority for the procedure was given.