Claudia Woolf, Clinical Neuropsychologist, talks to James about patient capacity and consent. Together they’ll go over the legal and professional responsibility of all clinicians regarding patient capacity and consent. Clinicians are required to obtain consent before treating any patient. In this podcast, we also discuss the questions raised regarding capacity and guardianship. These are often not well understood by clinicians.
Summary Writer: Nicholas Malouf
Editor: Bruce Way
Interviewee: Claudia Woolf
Claudia Woolf is a nationally endorsed Clinical Neuropsychologist. Claudia is a member of the Australian Psychological Society (APS) and College of Clinical Neuropsychologists. She is also a Ph.D. candidate enrolled at the University of Sydney under the supervision of Prof Naismith.
Claudia obtained her Bachelor of Psychology (Hons I) from the University of New South Wales in 2010. She followed that with her Master’s Degree in Psychology (Clinical Neuropsychology) from the University of Melbourne in 2013. Since then, she has worked at the Dementia Collaborative Research Centre and the Centre for Healthy Brain Aging on sentinel projects in Psychogeriatrics. These projects include the Sydney Memory and Aging Study (MAS), the Older Australian Twins Study, and the Sydney Centenarian Study as well as coordination of the International Centenarian Consortium. Claudia’s academic track record includes the publication of a number of peer-reviewed manuscripts and international and national consumer and scientific presentations.
Claudia holds an appointment in the School of Psychiatry, Faculty of Medicine at the University of New South Wales as a Research Associate. She also has an appointment within the APS College of Clinical Neuropsychologists as the Early Career Representative. She currently works full-time as a Clinical Neuropsychologist within the Psychogeriatric Mental Health and Dementia Service at St Vincent’s Hospital Sydney. Here, she recently headed-up the implementation of a group cognitive remediation program for older adults at risk of developing dementia.
Claudia is currently working toward the completion of her Ph.D. which investigates cognitive remediation in a clinical population of older adults with current depressive symptoms. At St Vincent’s Hospital, Claudia also works as the Project Officer for Psychogeriatric SOS (services-on-screen). This is a unique, clinician-to-clinician, e-health solution to provide specialist psychogeriatric expertise to older adults in rural and remote Australia. She has also been heavily involved in developing ‘A Workshop on Capacity – Online Module for Junior Medical Officers’.
With Ms Claudia Woolf, Clinical Neuropsychologist at St Vincent’s Hospital, Sydney, Australia
Introduction
It is a legal and professional responsibility of all clinicians to obtain consent before treating any patient. Obtaining consent requires the patient to have a comprehensive understanding and be able to make an informed decision about the proposed treatment. Most patients are capable of understanding information and hence providing consent. However, with some patients this is not so. The following case raises questions regarding capacity and guardianship that are often not well understood by clinicians.
You are the junior doctor on a surgical team and have been asked to consent an elderly male patient for a surgical procedure.
The patient’s notes show that he has a background history of dementia. The patient’s wife is present.
Guiding principles for determining capacity
In this case the wife happens to be the enduring guardian for the patient (and hence the person responsible). The wife gives consent for the procedure and the patient agrees as well. The next morning, shortly before the operation is to take place the elder son of the couple turns up very concerned and is not happy for the operation to proceed.
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