qwerty123A
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''A 40-year old schizophrenic patient needs hernia repair. Surgeon discussed the procedure with the patient who
understood the procedure. Can the patient give consent? ''

If someone has schizophrenia i believe they are deemed to not have sufficient capacity. However if they understand the information and can make use of it - do they have sufficient capacity?
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ForestCat
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(Original post by qwerty123A)
''A 40-year old schizophrenic patient needs hernia repair. Surgeon discussed the procedure with the patient who
understood the procedure. Can the patient give consent? ''

If someone has schizophrenia i believe they are deemed to not have sufficient capacity. However if they understand the information and can make use of it - do they have sufficient capacity?
Capacity is determined on a decision by decision basis and at the outset a person is always assumed to have capacity. If a patient can retain, understand and repeat the information required to make a decision then they have capacity to make that decision. It may not necessarily be one the physician agrees with but the patient does not have to explain their reasoning.

Schizophrenia certainly does not mean that the patient automatically does not have capacity.
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Beska
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(Original post by qwerty123A)
''A 40-year old schizophrenic patient needs hernia repair. Surgeon discussed the procedure with the patient who
understood the procedure. Can the patient give consent? ''

If someone has schizophrenia i believe they are deemed to not have sufficient capacity. However if they understand the information and can make use of it - do they have sufficient capacity?
That patient does have capacity to make a decision like that. If they understood the procedure, know what it entails, can think about it and then communicate a decision then it is possible for them to consent. Mental illness is not an immediate barrier to capacity. If for example in this situation the patient did not have consent due to an acute psychotic episode (stopped meds etc) you would delay the surgery until they had capacity to make the decision.
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qwerty123A
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(Original post by ForestCat)
Capacity is determined on a decision by decision basis and at the outset a person is always assumed to have capacity. If a patient can retain, understand and repeat the information required to make a decision then they have capacity to make that decision. It may not necessarily be one the physician agrees with but the patient does not have to explain their reasoning.

Schizophrenia certainly does not mean that the patient automatically does not have capacity.
Ah thanks for clearing that up for me The NHS website isnt really as straight to the point.
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Etomidate
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(Original post by qwerty123A)
''A 40-year old schizophrenic patient needs hernia repair. Surgeon discussed the procedure with the patient who
understood the procedure. Can the patient give consent? ''

If someone has schizophrenia i believe they are deemed to not have sufficient capacity. However if they understand the information and can make use of it - do they have sufficient capacity?
You've had lots of good replies already, but keep in mind that capacity isn't a binary, static thing.

Having capacity to consent to having your blood taken is very different to having capacity to agreeing to a risky, major operation for example. It's not that a person does or does not 'have capacity'. Having capacity is also dependent on the complexity of the decision being considered and can change over time.

With the schizophrenia, again there is a huge spectrum of capacity/incapacity. A patient may have the diagnosis but be in a period of remission or relative remission. They may be well enough to make xyz decision one day but then lack the capacity to make the same decision a month later depending on their clinical status.

As already mentioned, the basic acid tests are these:

Assume an adult has capacity unless reason to doubt it.
If in doubt, with a particular decision in mind, can they:
1. Receive the information
2. Understand it
3. Retain it and weigh up the pros and cons
4. Communicate their decision

A decision need not be 'wise' or in concordance with your own beliefs, but so as long as the above has been met, you must respect that decision.

In this particular case, you would need more information. But in the context of a simple little MCQ, the fact that it says the patient "has understood", it's prompting you to say that yes they do have capacity despite their schizophrenia.
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Asklepios
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(Original post by qwerty123A)
Ah thanks for clearing that up for me The NHS website isnt really as straight to the point.
I doubt you'd find much useful information on the NHS website, plus it'll be full of waffle

This is a good resource for ethics, plus more straight to the point: http://ministryofethics.co.uk/?p=6
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qwerty123A
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(Original post by Asklepios)
I doubt you'd find much useful information on the NHS website, plus it'll be full of waffle

This is a good resource for ethics, plus more straight to the point: http://ministryofethics.co.uk/?p=6
Thank you!
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