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1.5 Describe the actions to take if an individual cannot give informed consent to the treatment

A file with 'informed consent' written on it and a stethoscope resting on top

If an individual is unable to give their consent to treatment, tests or examination (perhaps due to not having the capacity to understand the implications) then the healthcare professional should investigate if the individual has a Lasting Power of Attorney (LPA) or Legally Appointed Deputy (LPD) for their health and welfare. These individuals are able to make healthcare decisions on behalf of the individual and consent can be obtained from them.

Nobody else, including family members and carers, can legally consent for another individual and should never be asked to.

If an individual does not have an LPA or LPD, a best interests meeting must be arranged by the healthcare professional to discuss the best interests of the individual. This meeting must invite everybody that has a stake in the individual’s health so as well as healthcare professionals, the individual’s family/friends should also be consulted.

If, at the conclusion of the meeting, it is decided that it is in the best interest of the individual to commence with the treatment, then the healthcare professional is permitted to go ahead with it.

1.4 Explain why it is important to ensure an individual is able to give informed consent to their treatment in line with legislation, policies or guidance

A file with 'informed consent' written on it and a stethoscope resting on top

It is essential that an individual is able to give their informed consent to treatment, test or examination prior to it commencing.

This is an important part of medical ethics and human rights legislation (see the Human Rights Act 1998).

For individuals with learning disabilities, there may not be immediate certainty that they are able to give consent as they may not have the capacity to make such a decision. Having capacity means that an individual is able to understand the information given to them and then use this information to make an informed decision.

The other two pillars of consent are being informed (the individual is given all the information they need to make the decision) and the choice being voluntary (the individual makes the choice of their own free will and without pressure from others).

Having said that, individuals with learning disabilities should always be considered as having capacity unless there is reason think otherwise. It should not be presumed that just because someone has a learning disability, they lack capacity.

1.3 Describe ways that healthcare services should make ‘reasonable adjustments’ to ensure that they provide equal access to individuals with a learning disability

A boy in a wheelchair with a nurse

There are many ways that healthcare services can make reasonable adjustments to make equal accessibility available to individuals with learning disabilities.

For example, organisations can ensure that their signposts are clear and easy to follow. Similarly, handouts such as leaflets and information sheets may need to be adjusted so that people with learning disabilities are able to understand them. This could be by using visual aids, using ‘plain english’/’easy read’ or providing alternative media formats such as CDs and DVDs.

Sites of healthcare services should ensure that they are accessible for people with physical disabilities. Simple changes like widening doorways so that a wheelchair can fit through or using automatic doors so that people do not need strength and stability to push/pull a door open can make a real difference.

Some individuals may need extra time to have information explained to them or may require home visits.

Carers of people with learning disabilities should be embraced as they will know how best to communicate with the individual, however conversation and questions should be directed at the individual themselves as they are the ones receiving the healthcare.

Medical records should keep a log of the individuals preferences so that the healthcare professional has the information they require to meet the individual’s personal needs during appointments.

1.2 Identify legislation which supports a rights-based approach to accessing healthcare

Legislation word cloud

The most obvious piece of legislation that supports a rights-based approach to accessing healthcare is the Human Rights Act 1998.

This defines the fundamental rights and freedoms that all individuals are entitled to, whether they have a disability or not. Each right is an article and they are collectively known as the Convention Rights.

  • Article 2: Right to life
  • Article 3: Freedom from torture and inhuman or degrading treatment
  • Article 4: Freedom from slavery and forced labour
  • Article 5: Right to liberty and security
  • Article 6: Right to fair trial
  • Article 7: No punishment without law
  • Article 8: Respect for your private and family life, home and correspondence
  • Article 9: Freedom of thought, belief and religion
  • Article 10: Freedom of expression
  • Article 11: Freedom of assembly and association
  • Article 12: Right to marry and start a family
  • Article 14: Protection from discrimination in respect of these rights and freedoms
  • Protocol 1, Article 1: Right to peaceful enjoyment of your property
  • Protocol 1, Article 2: Right to education
  • Protocol 1, Article 3: Right to participate in free elections
  • Protocol 13, Article 1: Abolition of the death penalty

NOTE: Articles 1 and 13 are excluded as they are fulfilled with the creation of the Human Rights Act.

The Equality Act 2010 makes it unlawful for individuals to be discriminated based on certain ‘protected’ characteristics of which one is disability. This means that healthcare providers must reasonably make healthcare accessible to people with learning disabilities.

 

1.1 Outline what is meant by a rights-based approach to accessing healthcare

Human Rights-Based Approach

A rights-based approach to accessing healthcare in relation to individuals with learning disabilities brings that person’s basic human rights to the forefront of the healthcare they receive.

Individuals with learning disabilities are first and foremost individuals and have the same needs and rights regarding healthcare as those without learning disabilities.

Therefore they should be implicit in their own healthcare and empowered to make their own decisions whilst being provided with information through media that they can digest and fully understand.

Healthcare providers should have well-trained staff that involve individuals with learning disabilities. When talking about an individual’s health they should speak to the individual rather than their family or support worker. They should presume that the individual has the capacity to make their own choices and discussions of sexual health should not be stigmatized.

In addition, individuals with learning disabilities should not be discriminated against and should be offered equal opportunities to access healthcare.