Summary Writer: Nicholas Malouf
Editor: Bruce Way
Interviewee: Claudia Woolf
Claudia Woolf, Clinical Neuropsychologist, talks to James about the legal and professional responsibility of all clinicians – obtaining consent before treating any patient and the questions raised regarding capacity and guardianship that are often not well understood by clinicians.
Claudia Woolf is a nationally endorsed Clinical Neuropsychologist and a member of the Australian Psychological Society (APS) and College of Clinical Neuropsychologists. She is also a PhD 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 and her Masters 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 including the Sydney Memory and Aging Study (MAS), the Older Australian Twin Study and the Sydney Centenarian Study including 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.
She holds an appointment in the School of Psychiatry, Faculty of Medicine at the University of New South Wales as a Research Associate and an appointment within the APS College of Clinical Neuropsychologists as the Early Career Representative. She currently works fulltime as a Clinical Neuropsychologist within the Psychogeriatric Mental Health and Dementia Service at St Vincent’s Hospital Sydney where she recently headed-up the implementation of a group cognitive remediation program for older adults ‘at risk’ of developing dementia and is currently working toward completion of her PhD 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), 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
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 many patients this is not so. The following case raises questions regarding capacity and guardianship that are often not well understood by clinicians.
Case – 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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