Patient Communication & Informed Consent Flashcards

A patient with schizophrenia refuses antipsychotic medication during a voluntary admission. What is the most appropriate initial response?

Answer: Explore the reasons for refusal, address concerns, and attempt to negotiate — do not impose medication without legal authority

A voluntary patient retains the right to refuse treatment. The clinician should explore reasons for refusal (e.g., side effects, insight, fears), attempt therapeutic negotiation, and only consider the Mental Health Act if the patient meets criteria for compulsory assessment.

When using an interpreter for a patient who does not speak English, which approach is most appropriate?

Answer: Use a trained professional interpreter, ideally not a family member

Professional interpreters ensure accuracy, confidentiality, and neutrality. Family members (especially children) should not interpret as they may filter information, lack medical vocabulary, and compromise confidentiality or create conflict of interest.

A patient asks for a copy of their medical records. Under the Privacy Act 2020, what is the general obligation of the health provider?

Answer: Provide access to records within a reasonable time, subject to limited exceptions

Under the Privacy Act 2020 (Information Privacy Principle 6), individuals have a right to access information about themselves. Health providers must respond within 20 working days and provide access subject only to limited grounds for refusal.

Which of the following best describes 'therapeutic privilege' and its standing in NZ?

Answer: Withholding information believed harmful to the patient — this is not accepted under the NZ Code, which requires full disclosure

Therapeutic privilege (withholding information to prevent distress) is not accepted under the NZ Code of Rights. Right 5 guarantees patients the information they need to make decisions. Information should be delivered sensitively, not withheld paternalistically.

A doctor is about to perform a lumbar puncture. Which elements must be covered in obtaining informed consent for this procedure?

Answer: Purpose, process, risks, benefits, alternatives, and the right to withdraw consent

Informed consent requires explaining: why the procedure is needed, how it is performed, risks (including uncommon but serious risks), benefits, alternatives (including doing nothing), and confirmation the patient can change their mind.

A 10-year-old child is brought in by one parent who consents to a tonsillectomy. The other parent (with equal guardianship) has not been consulted. What is the most appropriate action?

Answer: Attempt to contact the other guardian before proceeding with elective surgery; emergency surgery can proceed with one guardian's consent

For elective procedures, both guardians should ideally consent. If one guardian cannot be reached and the procedure is not urgent, surgery should be deferred. In emergencies, one parent's consent (or implied consent if neither available) is sufficient.