{"id":2168,"date":"2018-01-10T12:21:00","date_gmt":"2018-01-10T17:21:00","guid":{"rendered":"https:\/\/live-coto.pantheonsite.io\/?post_type=resource&p=2168"},"modified":"2025-01-21T15:23:45","modified_gmt":"2025-01-21T20:23:45","slug":"obtaining-informed-consent-for-an-incapable-client-when-an-sdm-is-not-available","status":"publish","type":"resource","link":"https:\/\/www.coto.org\/resources\/obtaining-informed-consent-for-an-incapable-client-when-an-sdm-is-not-available\/","title":{"rendered":"Obtaining informed consent for an incapable client when an SDM is not available"},"content":{"rendered":"\n\n
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Background<\/h2>\n <\/div>\n\n
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Lily, an occupational therapist (OT), was notified by staff at a group home that her client, Davon required a new wheelchair cushion. The cushion had a leak and was putting the client at risk for skin breakdown. Lily went to the group home to see her client and reassess him for a new wheelchair cushion.<\/p>\n\n\n\n

While reassessing Davon at the group home, Lily realized that his cognition had declined since her last visit and he no longer had the capacity to consent to the proposed occupational therapy treatment. Lily discussed this with the group home staff, who had also noted a recent change in Davon\u2019s cognition. Through further discussion with the staff, Lily determined that Davon\u2019s only remaining family member, his dad, had recently passed away leaving no one available to act as a substitute decision maker (SDM).<\/p>\n\n\n\n

Lily decided to contact the Office of the Public Guardian and Trustee (OPGT). She explained that she needed to obtain informed consent for her proposed treatment. She was told by the OPGT staff that it may take some time to obtain informed consent as it involved a process of starting a file for the client, examining the process used to deem the client incapable, and examining the treatment being proposed. Lily was informed by the OPGT that if the treatment she was proposing constituted minimal to no risk, she could use her judgement and determine if she should proceed without obtaining informed consent.<\/p>\n\n\n\n

Lily was aware of the expectations to obtain informed consent for her occupational therapy treatment according to the Standards for Consent, however, waiting for the group home to locate another possible SDM or waiting for the OPGT to provide consent could put Davon at risk of skin breakdown. Lily considered her options.<\/p>\n\n<\/div>\n <\/div>\n<\/div>\n\n\n\n

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Considerations<\/h2>\n <\/div>\n\n
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