PTSD Treatment Informed Consent

This assignment examines the ethical considerations surrounding informed consent when treating Post-Traumatic Stress Disorder (PTSD) in a minor patient named Lalah. It emphasizes the crucial role of parents due to Lalah's age, highlighting the need for their involvement in both diagnosis and treatment decisions. Additionally, it addresses the importance of qualified medical interpreters to ensure clear communication with Lalah and her family, who have limited English proficiency.

Running head: NURSING ASSIGNMENT
Nursing Assignment- Valid consent
Name of the Student
Name of the University
Author Note

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In healthcare, valid consent is an essential component where the healthcare provider
discloses information to a patient who is competent enough to make voluntary choice in
accepting or refusing treatment. It is the legal and ethical rights of a patient to know and direct
what happens to their body However, there are various forms of barrier that is witnessed in
getting a valid consent from the patient. In the given case study, Lalah Khalili, a 14-year-old girl
is suspected with post-traumatic stress disorder and to give her a mild sedative, conduct and ECG
and take a blood test, a valid informed consent is required. However, she is a minor and lack
judgment power to make able decisions for her. In such cases, her parents have to provide a valid
consent, but they have limited English ability. Therefore, the following essay deals with the
discussion of importance of valid consent, barriers for the valid consent and solutions for getting
the valid consent.
A person who has the capacity to make effective decisions about a specific issue gives
valid consent and free from any influence or manipulation that might alter the decisions made as
stated by Queensland Health, Australia (Queensland Health, 2013). When a transparent decision
is made between the patient and healthcare professional, it offers balance and sensitivity to the
situation. Information must be given to the patient or any reasonable person who can make
reasonable valid consent in the patient’s position. Impaired informed consent leads to 11.5% of
conciliated complaints and 3.4% of medical negligence in the valid consent process (Grady,
2015). Moreover, a person who is minor (below 18 years of age) is considered minor and
requires parents or a legal guardian to provide valid consent on behalf of the child’s treatment.
However, under the Australian Law, teenagers are recognized as competent to provide informed
consent for themselves, as they get older. Parents and their minor children hold concurrent rights

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in providing consent for treatment for minor patients below the age of 18 years. There is various
type of consent like implied, verbal and written form.
In the given case study, although Lalah Khalili has the ability to make decisions for
herself, it should be taken under the vigilance of her parents. In healthcare, nurses have the
responsibility to work within the law that shape their nursing practice. Under Registered Nurse
Standards for Practice in Nursing and Midwifery Board of Australia (NMBA), valid consent is
an ethical and legal obligation. Failure to obtain a valid consent is considered a criminal offence
and tort of law (Cashin et al., 2017). They have the obligation to work under ethical frameworks
when they make efficient decisions during assessment, planning, action and evaluation. In the
given case study, before the administration of mild sedative, conduction of ECG and blood test, a
valid informed consent is important to obtain. However, there are barriers witnessed in this
situation that will be discussed in the next section.
A nurse should take care of the fact that the patient is providing her consent to the
treatment procedures voluntarily and without any coercion feelings. She should be able to
understand the intervention elements and make a necessary choice for receiving the intervention.
However, one major issue that occurs in obtaining valid consent of minors in health intervention
is the disruption of balance between the vulnerability and immaturity of the minor and the right
to get emancipated from parent’s decisions. The physicians and nurses are not supposed to
assume that a patient lacks the capacity of providing consent based on her behavior, age,
appearance, disability, beliefs, literacy or socioeconomic status, or mental health condition (such
as post traumatic stress disorder). Age influences, language barriers and mental stigma can
hinder effective communication between the nurse and the patient while obtaining consent. The
nurses should take care of the fact that valid consent will have to be provided to the patient,

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Lalah Khalili in a language that she and her parents can comprehend and understand. It is known
that she and her brother are good English speakers. If the consent is provided to her in English
language, the quality of interpretation of the consent will be correct. However, if there is the use
of a language not known to her, it can lead to misunderstandings and incorrect responses.
Furthermore, her parents should also be involved in the process of providing consent owing to
her young age. If her parents are non-English speaking, poor translations from the staff can lead
to dangerous misinterpretations and misdiagnosis (Lee et al., 2017). This will lead to decline in
patient care quality and satisfaction. Another barrier is the age of the patient. Australian laws
related to medical treatment recognize that patients aged 18 years or more have the legal capacity
to make decisions related to self healthcare (Bismark et al., 2012). Prior to 18 years of age, the
legal guardian or parents are entitled to provide consent to the medical treatment of their child.
Minors are generally not allowed to give consent to own treatment, except when they are in the
military or married. However, the law states that teenagers become competent with development
and are at times capable to get involved in the process of obtaining the consent (Law Reform
Commission, 2008).
Depending on the age and competency, minors can be approached for participation in
giving valid consent. The nurses and physicians would have to judge the each patient based on
their individual capacity. Moreover, the nurses will also have to evaluate whether the patient
demonstrates sufficient knowledge of her health condition and a sound understanding of the
necessary medical interventions that include the adverse effects that can occurs and the
impending dangers that can arise if she withdraws from the treatment. Another barrier that can
arise while obtaining consent is the patient’s medical condition (Spatz, E. S., Krumholz, H. M.,
& Moulton, B. W. 2016). She has been admitted after an episode of post traumatic stress

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disorder. This condition can arise as a result of some traumatic experience and is a form of
anxiety disorder. Often patients suffering from PTSD witness some events that create an impact
on their mental health. The concerned patient and her parents may not allow consent to
therapeutic interventions due to fear of stigmatization from the mental condition, embarrassment
issues and fear of less availability of specialist therapies. The altered mental state of the patient
may make her incompetent to judge the process of intended medical treatment. This will create a
hindrance in giving consent for interventions.
Nursing profession recognizes human rights universally and regards safeguarding patient
dignity as a moral responsibility. According to the code of ethics for Australian nurses, they
should value informed consent and decision making while catering to the needs of their patients.
They should value the moral and legal right of all patients to participate in decision-making
events related to their healthcare concerns (Nursing & Council, 2008). This involves avoiding
any cultural stereotype based assumptions. They should use relevant illustrations and written
information to depict the patient’s current physical condition and the possible route of
therapeutic intervention. They should arrange for a qualified health interpreter to overcome
language barriers prior to consultation (Douglas et al., 2012). A registered nurse who has
undergone extensive training is eligible to take delegated consent. Nurses should also respect and
recognize their patient’s wishes once the latter is fully informed and has the capability of take
decisions. However, if the patient declines giving consent to any life-saving treatment methods,
the nurse should immediately consult substitute decision makers and seek second opinion from
medical practitioners.
When the patients are unable to provide consent owing to young age, disabilities or legal
constraints, the nurses should recognize and efficiently utilize the contribution made by parents

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or legal guardians for providing effective treatment facilities. Nurses should be knowledgeable
about these circumstances and should facilitate the role of partners, family members and friends
in decision-making processes. Patients with limited literacy on health issues should be described
the plan for medical treatment to fill in the gaps in their analysis of the current situation. The
reason for ambivalence shown by the patient should be ascertained (Simonds, Garroutte &
Buchwald, 2017). They should be given time to reflect on the suggestions provided and to
reconsider their health status. The social and cultural history of the patient should also be
considered in case it poses a hindrance in giving consent. Any form of stigmatizing attitudes
associated with mental health status should be removed (WA Health, 2016). This can be done by
creating awareness among the patient and the family members regarding the underlying causes
of mental disturbances and the effective treatment procedures that can be adopted to reduce the
symptoms. It is the legal and ethical obligation of a nurse to inform patients about the risks
associated with noncompliance. They should also reassure their patients that the medical team
will provide the best facilities to help the patient. Regardless of whether consent is obtained or
not, nurses should document all details relevant to the proposed treatment (Hoeyer & Hogle,
2014). Well documented consent will verify that the nurse and physicians have met their
obligations in providing necessary information to the concerned patient about possible treatment
options.
From the above discussion, it can be witnessed that obtaining a valid consent is important
in the healthcare and nursing practice. Healthcare professionals have to work in accordance with
the law and ethics to provide the best quality of care and ensure patient safety. In the case study
of Lalah Khalili, various barriers were observed while obtaining an informed consent like
language, age and lack of health literacy. As she is a minor, her parents must be involved in

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obtaining the informed consent before the diagnosis and treatment process. Moreover, her
parents have limited English ability and in such cases qualified medical interpreter is required
who would provide accurate information to Lalah and her family that aid in taking able decisions
for her PTSD treatment.

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References
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