The decision to undertake a procedure to administer blood or blood product to a patient who is unable to provide consent or for whom there is no legal representative is ultimately the responsibility of the doctors caring for the patient. However, it is the Canterbury District Health Board's policy to consult, where practical, members of the patient's family, significant others and/or anyone else with a legitimate interest in the care of the patient, in order to help determine what the patient's wishes might be.
I (Doctors name)_____________(print) (Designation) ________________hereby certify that the Condition of (patients name) _________________________(print) was such that consent could not be obtained prior to the procedure of: ________________________________________________
Which I further certify is, in my opinion, in her/his best interests.
In reaching this opinion I have taken into account information provided to me by others interested in her/his welfare, the signature of one of whom appears below as witness.
OR
In reaching this opinion, I have consulted with colleagues, the signature of one whom appears below as witness.
SIGNED:___________________________ DATE: _______________ TIME: _____________________
SIGNED: __________________________ DATE: _______________ TIME: _____________________
NAME OF WITNESS: _____________________(print) (Relationship/Designation) ________________
| Procedure to be followed when a patient or legal guardian cannot / is not available to provide consent: |
| 1 | Reasonable attempts have been made to obtain consent, or the time to do so was not available in terms of the patient's interests. |
| 2 | They are in a position to document justification for preceeding without obtaining consent |
| 3 | Where time permits, the specialist having overall responsibility for the patient is aware of the proposed action |
| 4 | Where approriate and time permits the specialist in charge has sought an alternative option from another senior staff member not involved in the patient's care. |
| In non-urgent situations reasonable steps must be taken to ascertain what the patient's informed choice might be in the given circumstances. This may necessitate seeking opinion from others having an interest in the welfare of the patient. In this regard, staff are referred to Right 7 (4) of the Code of Health and Disability Services Consumers' Rights. |