SJT: Adult Consent Law — Montgomery & Capacity (passthemsra.com) - Free MSRA revision

Consent is one of the most tested — and most misunderstood — areas of the MSRA SJT. This episode distils the entire legal and ethical framework for adult consent, combining GMC Good Medical Practice, the Montgomery ruling, and the Mental Capacity Act 2005 into a practical, exam-ready blueprint.We break down capacity, voluntariness, material risks, reasonable alternatives, teach-back, documentation standards, and the traps around refusal and family pressure. This is your complete high-yield guide.0:00 Why adult consent is high stakes00:20 The three pillars: capacity, voluntariness, informed choice01:20 The Montgomery revolution (2015)02:00 Material risks defined “in this patient’s position”03:30 Tailoring risks to personal values (musician example)04:20 Reasonable alternatives — including doing nothing05:40 Consent as a process, not a signature06:20 FIRST → NEXT → LAST framework07:00 Step 1: Outline all options + patient goals07:40 Step 2: Explain material risks + alternatives08:40 Step 3: Teach-back (“tell me in your own words…”)09:30 Step 4: Assess capacity only if there are red flags10:20 Step 5: Documentation that meets GMC 202410:55 The CHOICE mnemonic11:40 The MCA four-part capacity test12:40 The biggest trap: unwise ≠ incapable13:20 Family disagreement — autonomy prevails14:10 Respecting refusals + lawful safety-netting15:20 What good documentation must include16:40 Final three high-yield takeaways17:30 Reflective question: how child competence differs• Consent requires capacity, voluntariness, and informed choice — all three must be present.• Montgomery replaced Bolam: disclose all material risks and reasonable alternatives.• Material risk = what a reasonable person in this patient’s position would find significant.• Always individualise risk: values, occupation, goals, priorities.• Teach-back confirms genuine understanding — “Do you understand?” is unsafe.• Capacity is decision-specific and time-specific; assess only when indicated.• Unwise decisions do not imply lack of capacity.• Family cannot override a capacitated adult.• Document risks discussed, alternatives, patient priorities, teach-back, and the final decision.CHOICEC – Check capacity (if red flags)H – Help understanding (teach-back)O – Outline all optionsI – Individualise risksC – Confirm decisionE – Enter notesMCA 4-Part TestUnderstandRetainUse & weighCommunicateAdult consent law is built on autonomy.Your duty is to provide tailored information, ensure comprehension, assess capacity when needed, respect refusals, and document meticulously. Apply the FIRST → NEXT → LAST structure, coupled with CHOICE, and your consent discussions will be safe, lawful, and high-scoring.Links:• passthemsra.com – Complete MSRA revision, notes, mocks, flashcards• freemsra.com – Free podcasts, threads and rapid-learning guides• msra.io – Smart MSRA Qbank with analytics#MSRA #SJT #Consent #Montgomery #Capacity #GMCGuidance #MentalCapacityAct #PatientAutonomy #MedicalEthics #UKDoctors #MedicalRevision #passthemsra #freemsra #msraio