Patient Communication & Informed Consent Flashcards

Which of the following best describes 'informed consent' under the NZ Code of Health and Disability Services Consumers' Rights?

Answer: Voluntary agreement given after receiving adequate information, understanding it, and having capacity to decide

Under Right 7 of the Code, informed consent requires: the patient has capacity, information has been provided and understood, consent is freely given without coercion, and the patient has the right to withdraw. A signature confirms but does not replace genuine informed consent.

A 16-year-old presents alone requesting contraception. She appears to understand the information provided. What is the legal position regarding consent in New Zealand?

Answer: A 16-year-old can consent to medical treatment independently under the Care of Children Act 2004

Under the Care of Children Act 2004, a person aged 16 or over can consent to medical, surgical, or dental procedures as if they were an adult. Under 16, the Gillick/Fraser competence principles apply — the child may consent if they understand the information.

When explaining a diagnosis of cancer to a patient, which communication approach is recommended?

Answer: Use clear language, pause frequently, check understanding, allow silence, and invite questions

Breaking serious news (SPIKES protocol) involves a structured approach: check what the patient knows, ask how much they want to know, give information in clear chunks, explore emotions, summarise, and plan. Patient-centred communication improves coping and trust.

A patient has capacity but refuses a blood transfusion that the doctor believes is life-saving. What is the correct action?

Answer: Respect the refusal, document it thoroughly, and explore the patient's reasons and wishes

A competent adult has an absolute right to refuse medical treatment, even if the refusal is unwise or life-threatening. The doctor must respect this, document carefully, ensure the patient understands consequences, and continue to provide care within the patient's wishes.

Which of the following is NOT a valid reason to override a patient's right to confidentiality?

Answer: The patient's partner requests information about their diagnosis

Confidentiality cannot be overridden simply because a partner or family member requests information. Valid exceptions include disclosure to prevent serious harm to others, statutory obligations, and sharing within the treating team on a need-to-know basis.

Which model of patient communication is most aligned with the NZ Code's emphasis on partnership and shared decision-making?

Answer: Collaborative/shared decision-making model

Shared decision-making (collaborative model) aligns with the Code's emphasis on patient autonomy and partnership. It involves exploring patient values and preferences alongside clinical evidence to reach a mutually agreed treatment decision.