233 Potential Deprivation of Patient Liberty: A Qualitative Study of Current Practice Amongst Geriatricians in a Tertiary Setting. (16th September 2019)

• Record Type: Journal Article
• Authors: O'Brien, Michelle; O'Donnell, Deirdre; Clyne, Barbara
• Is Part Of: Age and ageing. Volume 48(2019)Supplement 3
• Page Start: iii17
• Page End: iii65
• Publication Date: 2019-09-16
• Subjects: Aging -- Periodicals; Geriatrics -- Periodicals; 618.97
• DOI: 10.1093/ageing/afz103.140
• Languages: English
• ISSNs: 0002-0729

Abstract

Abstract: Background: The Assisted Decision Making (ADM) Act 2015 was introduced to support decision making and maximise a person's capacity to make decisions but has not yet commenced. Within this context, medical professionals such as geriatricians must adjust from a best interest's outlook to that of patient autonomy in response to the changing legislation. The aim of this study is to explore current geriatrician's practice. In scrutinizing current practice, it will be evident as to what, if any, adaptations are required in order to practice in accordance with the new legislation. Methods: Ten semi-structured interviews with individual consultant geriatricians were conducted, each lasting approximately 20 minutes on average in one hospital. Each interview was recorded and transcribed verbatim. The interview involved the geriatrician reading a vignette and answering questions as to how they would manage this situation. Following the vignette, the semi-structured interview proceeded covering topics including; patient decision making in the acute setting, deprivation of patient liberty in the acute setting, thoughts on the ADM (Capacity) Act 2015, and elements learned from experiences in other countries. A thematic analysis was conducted. Results: Preliminary themes identified from the interviews include; (a) identification, accessibility and availability of medical and legal colleagues in assisting with difficult decision making, (b) need for clear frameworks, guidance and education in relation to laws applying to medical practice, (c) influence of environment, family, perceived risk and delirium on capacity assessment, (d) paternalism versus autonomy. This work is being conducted as part of a master's in healthcare ethics and law. Conclusion: Preliminary results highlight the need for collaborative communication between medics and the legal profession in order to achieve a structured and supportive framework to inform practice considering the new legislation.