Intellectual Disability and Consent and Decision-Making - Clinical Opal

Answer

When a person has complex communication needs, it is important to work with their support team who can assist you in understanding the person. Best practice is understanding each person’s communication needs and methods, and speaking with the person directly, regardless of whether the communication is verbal or non-verbal. 

You needed to establish consent with Minh before and during the procedure. If consent cannot be established with Minh, then a substitute decision maker, in this case, Minh’s mother, would provide consent on his behalf. In this case, she had asked that your team wait for Minh’s trusted support worker to arrive. This would have saved Minh from another traumatic experience. 

In NSW, if a person is unable to understand the general nature and effect of a particular health treatment or is unable to indicate whether they consent, substitute consent can be provided by the person responsible.   

A person responsible is the first on the following list who exists for the person: 

1. An appointed guardian, with the appropriate medical and dental decision-making authority. 
2. The person’s spouse or de facto spouse where there is a close and continuing relationship. 
3. An unpaid carer or the carer at the time the person entered residential care (recipients of a government carer benefit are not considered to be paid).
4. A relative or friend who has a close personal relationship with the person.

Further learning

For more information, strategies and to learn about best practice in inclusive care for people with intellectual disability enrol in the online learning module Just Include Me - Inclusive Health Practice brought to you by the Council for Intellectual Disability.