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After watching the video, I do not think that Thomas can consent to his own treatment and he may require the help of his caregiver. I think he does not have the mental capacity to make an informed decision or provide informed consent because in order for consent to be informed you must understand what you are consenting to. I think Thomas was saying yes because he was eager and excited to be where he was, not because he understood what was happening. He also seems like a very enthusiastic and happy person who agrees with others to keep them happy. Thomas relied on his mom throughout the video which portrays that he relies on her to help with many things. The caregiver should be utilized in this situation to help Thomas with understanding. The risks and benefits of the procedures should explained to the mom so that both parties can better understand the situation.

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After watching this video clip, I do not believe that Thomas is capable of giving informed consent for treatments. He seemed to lack understanding of what DH presented to him, and he simply agreed without fully comprehending what he was agreeing to. Thomas's mother answered for him and explained the treatment to him. To provide consent, a client must understand the procedures they are undergoing and the associated risks and benefits. However, in this video, Thomas was looking to his mother for answers, indicating that he did not fully understand the situation. In this case, his mother acted as his Substitute Decision Maker (SDM). It is important for us to assess if the client is able to make their own decisions, and it's also crucial to involve a caregiver or family member to assist the client for their overall health and safety.

Suhyang Jang

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Due to Thomas' circumstances in the video, I do not think he is able to provide consent to dental treatment because in order for informed consent to take place, Thomas must understand the procedures. This is why Thomas' mother should be involved in his treatment, in order to make decisions on his behalf and ensure he is being treated properly. However, I think that Thomas should still partake in the discussion of the treatment as best he can so that his perspective is still included in the decision-making process. This may also reduce the anxiety that many people feel when at the dentist because he may be more aware of what is going on.

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After watching the clip, I do not think Thomas is capable of providing consent. I still feel that Thomas has not been given the full information on what he was going to be treated for. For example, the part where the SDM talked about permanent teeth and tried to remind Thomas of that. I noticed a lot in the video that Thomas does rely on his mom a lot to not only make the decisions but overall do the communicating as well. He would look back at his mom to speak for him or translate what he had said to the other speaker behind the camera. Overall, while many people with Down syndrome can lead independent lives and make their own decisions, others may require support in decision-making due to intellectual disabilities or other associated conditions. For example, depending on ones severity of intellectual impairment, the complexity of the decision to be made, and legal requirements may necessitate the involvement of a substitute decision maker. In the video you can see that the mom is acting on behalf of the person with Down syndrome (Thomas), making decisions in their best interests when they are unable to do so themselves. It's important to ensure that decisions made by the substitute decision-maker align with the person's values, preferences, and wishes as much as possible. You can notice that Thomas is very comfortable allowing his mom to do the speaking. In some, it may not be the case such as avoiding speaking at all or avoiding eye contact.

Sahar Ahmad

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From watching the short video clip, I feel that Thomas is not capable of providing consent. Even in this interview, it is clear he has a caregiver/SDM that is able to speak for him and assist him in decision making. In this situation she had to remind him of what procedures he wanted to have done, which on its own is not a determinant of being able to provide consent, but when combined with his condition I believe that providing informed consent would be incredibly difficult. He may agree on a suggested treatment without fully understanding the procedures involved including the risks and benefits associated with it. He also may not understand his right to refusal, and instead agree with the DH simply because they are an authority on the matter.

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Based on the short video clip, I think Thomas is not capable of providing consent. In order to receive informed consent, the client has to understand ( Thomas has down syndrome with is a disability that he may not understand everything) what the professional is saying or asking, as well as being aware of the risks and benefits. In the video when the professional asked Thomas questions, he was unable to answer to the fullest and then his mother stepped in. He would just repeat what his mother said even thought he did not understand. In this case it is important for the professional to explain the procedures to Thomas, however get the consent from the mother.

Sidney Reinhart

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Based on the video, I do not believe Thomas is capable of providing consent on his own. To give informed consent, the individual/ client must be able to fully understand the procedures, risks, and benefits. The decision maker appears to be Thomas's mother, where he looks for input after. Due to Thomas's cognitive impairment due to having Down Syndrome, it would put him at risk if he was not able to understand why he is getting a procedure done on his own. However, collaborating with both the substituted decision maker (the mother) and Thomas, it will include him in the decision process but will allow a definitive answer for the healthcare professional to properly proceed.

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As a healthcare provider, assessing Thomas's capacity to provide consent involves a comprehensive evaluation of his understanding, decision-making abilities, and communication skills, particularly considering his Down syndrome diagnosis. While every individual is unique, Thomas's ability to comprehend the nature of the decision, weigh its risks and benefits, and effectively communicate his preferences are paramount factors. If Thomas demonstrates a clear understanding of the decision at hand, expresses his preferences, and exhibits the ability to make reasoned choices consistent with his values, he may possess the capacity to provide consent. However, if he struggles significantly in any of these areas, additional support and assessment may be required to ensure his well-being and protection. Collaboration with Thomas's support network is essential to gain insights into his capabilities and preferences while upholding his autonomy to the fullest extent possible.

Nada Thary

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After this short clip, I do think that Thomas is aware of what is going on and is capable of making certain decisions. In the case of dental care, I think that having a SDM would be beneficial to ensure that informed consent it being obtained. With Thomas, it is difficult to interpret how much understanding he has when it comes to more complex procedures. In the video, the mother did do a lot of talking which does lead me to think that Thomas' confidence is not a completely accurate determination of his knowledge and understanding. It seems as though he also puts a lot of trust into his mother and agrees with all her wishes, I do think that his mother would be a good SDM for Thomas.

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I do not believe Thomas is capable of giving consent for his treatment. This is because he seemed to just be repeating things he was told by his mother in a previous conversation, rather than giving his own answers. When he didn't know the answer or didn't finish saying everything his mother wanted him to say, she spoke for him and spoke as if it was his idea, and he agreed. It almost seemed like he didn't really know what she meant about the permanent teeth so just nodded along. Providing consent means you understand all aspects of your care and what means for your health. In this case, his mom seems to know what he needs and what his care entails, so she should be his substitute decision maker.

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As a healthcare worker, it's important to figure out if Thomas can understand and agree to medical treatments. His ability to get what's going on might be different. Thomas seems to trust his mom to help him understand what's happening at the dentist. This suggests he might not fully get the details about his treatment, like what might go wrong or what other options he has. So, it's likely he can't decide on his own.

Therefore, Thomas might not totally get what's happening at the dentist because of his condition. He relies on his mom to explain things, showing he might not be able to decide for himself. So, his mom should be the one to agree to any dental work for him, since she knows him best.

Rawaa Thary

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After watching the video, I do not think that Thomas is able to provide consent. Informed consent involves understanding the treatment, risks and benefits, and alternate treatments. He was not sure about the procedure he was getting done and had to ask his mother. She explained that the flipper was temporary and he needed permanent teeth which he agreed to. I think he is agreeing because he trusts his mother not because he understands the procedure. Therefore, having his caregiver or SDM, in this case his mother, in the dental office would be beneficial to all. It is important to include Thomas in the discussion and explain in simplified language the procedure and process. Although, before the procedure starts consent should come from his SDM.

Carina Da Silva

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After watching the video, I believe that Thomas does not have the ability to consent to treatment. Consent is a very important aspect to our career and it is important to understand when someone is not able to give it. He did not have a full understanding of the procedures that were being explained. It was also important to note that his mother was the one who was doing most of the talking as Thomas has an intellectual disability called down syndrome. Extreme happiness is a side effect of down syndrome, and Thomas presents with this. Due to this, it interferes with Thomas's decision making as he always wants to keep the mood high and happy. He also explained that his reasoning to have his teeth cleaned was to please his parents. In this circumstance, a SDM may aid in giving consent to ensure that his best interests are being considered.

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After watching the video, I do not think Thomas is able to provide consent. Consent must be given after explaining the risk and benefits of a procedure and it seems that Thomas may not have the capacity to completely understand. In the video, Thomas looked to his mom mostly during the interaction waiting on her to respond for him. This suggests he depends on his mother's assistance to answer questions for him, and he is not able to understand the treatment or the risks and benefits. As his dental hygienist, I would take consent from his mother, but still to be sure to include Thomas within the conversation as the treatment will be done on him. I would always make sure to have his caregiver present with him during appointments, explain the risks and benefits to the procedures planned, and be sure to provide plenty of visuals to help Thomas know what to expect during treatment.

-Brianna Pao

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Based on the video, I do not think Thomas is capable of providing consent. From what I could observe, Thomas did not seem to fully understand the procedures they were planning to take place. He seemed to rely on his mother for guidance and answers. To be able to give content, a client must fully understand the treatment, risks and benefits, and alternate options if they don’t want to go further. Thomas would benefit from having a substitute decision-maker but he should still be informed and included in the decision-making process. - Lana Dankha

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Based on the video, it appears that Thomas may not possess the capacity to provide informed consent independently. due to some factors

Firstly, Thomas's cognitive abilities may be impacted by Down syndrome, potentially affecting his understanding of the risks and benefits associated with the treatment provided. Secondly, Thomas seems dependent on his caregiver to answer and prefers to agree with their responses without demonstrating a deep understanding of the situation, this was seen by him turning to his caregiver, for guidance and assistance in responding to questions asked by the dental hygienist. Third, he may simply be seeking to please those around him rather than fully understanding the effect of his decisions.

That being said, the dental hygienist can still engage with Thomas and take his responses into consideration while also allowing him to explore what type of treatment he needs to get done by using visual aids like pictures or videos that can help him have a better idea.

In short, Thomas may not possess the capacity to provide informed consent independently. Collaborating with his caregiver to make decisions that prioritize his health and safety is essential in these cases.

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In relation to this clip of Thomas, I feel that he may lack the ability to provide consent. For one to grant consent, an individual must comprehend the risks and benefits of procedures when presented with them. Thomas's reliance on his mother for decision-making during the dental appointment suggests he may not fully grasp these aspects and needs a substitute decision-maker. Therefore, seeking consent from a caregiver, like his mother, seems more suitable in this situation. That being said, Thomas's autonomy should be respected and the care provider should still keep him informed and a part of the decision-making process.

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Based on the video, it appears that Thomas may lack the capacity to make decisions for himself without support due to his mental limitations and difficulty understanding procedures. His mother seems to play a crucial role in guiding him through decision-making processes and advocating for his needs. Given these challenges, it may be important to involve his mother or another trusted guardian in any discussions or decisions regarding his care and well-being. This support will ensure that Thomas's rights and interests are protected and that he receives the appropriate care and assistance he needs. Collaborative decision-making involving Thomas, his mother, and healthcare providers can help create the best possible outcomes for his health and quality of life. Molika

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After watching the video and as a health care provider, I think Thomas is not capable of providing consent to treatment on his own. The interaction with his mom seemed like he wanted validation from her whenever he wanted to answer any question that he had been asked for. His mom answered the majority of the questions for him and he looked like he was following whatever she was deciding for him. This indicates that he is not completely able to understand the treatment plan, risks and benefits of it, as well as he was waiting for his mom to answer the question instead of him. Thomas seemed very agreeable with his mom deciding for him and this is another reason that proves he is not able to provide consent to treatment on his own. Involving Thomas in the decision-making process is an asset in making sure he will be compliant with the treatment to avoid any future issues that may occur. However, providing visual images, and videos or explaining things in a very easy and simple way is a great idea that will make the information reach him as easily as possible.

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When evaluating whether Thomas can give consent, we need to think about a few things. First, how well does he understand the information being presented to him? Can he clearly communicate what he wants? Does he realize what might happen because of his decisions? Because Thomas has trouble speaking and understanding complex medical terms, it might be hard for him to fully understand what's going on or to say clearly if he agrees or not. Another factor is because of his Down Syndrome his cognitive capacity could be affected making his ability to grasp the risks and benefits of medical information extremely difficult. Overall it seems like Thomas might not be able to make informed decisions on his own. When dental hygiene providers work with Thomas, they need to do it in a way that respects him and his needs. It's important to involve his family or caregivers to make sure whatever decisions get made are in his best interest and keep him safe.

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My thoughts after watching this video are that Thomas is not capable of providing consent to treatments. I believe this because not only is it apparent he has several forms of mental disability, but he also demonstrated that he was not able to understand questions that was asked to him. It was shown when they tried to talk directly to him and he was unsure and looked towards his mom to answer for him. For this reason I believe he would need a caregiver present to give consent and also to make sure he is comfortable. If I were his dental hygienist I would not feel comfortable getting consent from Thomas and would make sure that a caregiver is always present during an appointment with him.

- Janelle Hill

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After watching the video clip, I do not believe that Thomas is able to consent to treatment on his own. He was not able to understand the treatment that the dental hygienist was describing, and turned to his mother, potentially his SDM, to answer for him and to describe the treatment for him. To be able to provide informed consent, the client must fully understand the treatment being provided as well as the risks and benefits. In the video, Thomas was looking at his mom for answers and explanations, showing that he does not fully understand the treatment about to be provided. This means that Thomas can not provide informed consent for himself, but his mother can be his SDM and can be involved in his treatment.

Jasmine Hutchison

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After watching the video clip I do not think Thomas is able to provide consent on his own. Although he understands he would like his teeth cleaned I do not think he fully understands what the dental hygienist is saying. I do think it was helpful to have a caregiver beside him when they were talking with the hygienist. The caregiver can help talk with the dental hygienist about what treatment they would like done. I also noticed that when the caregiver said "We need to get the permanent plate thing" Thomas turned to her so that she could help him answer. In a case like this where he is relying on her to help him get his point across I think it is especially important to note he can not consent on his own. Even though his caregiver is talking for him it seems like they came up with a plan together regarding what needed to be done. Therefore, I think it was important that she included him in the decision-making which is important because although he cannot consent by himself, it is important to include Thomas in the discussion and plan for the appointment. - Sydney Urion

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In this case study and after watching the video it can be determined that Thomas is not fully capable to provide informed consent to treatments. He did not seem to have full comprehension of the things the DH was explaining. He also seems to have a very reliant relationship with his mother who is potentially the SDM in this scenario. Although consent in this case is likely derived from the care giver, it is still important to discuss treatment and procedures with Thomas as well as the care giver in order to derive fully informed consent from those who are involved. Recognition of risks and benefits of the care giver is significant in moving forward with treatment, and in this case I do not believe that Thomas is able to make that decision for himself. - Patricia Jambor

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While watching the video, I don’t believe that Thomas, himself, is able to give consent for treatment on his own. He doesn’t seem to have an understanding of the questions asked and doesn’t seem to have an understanding of information provided from his guardian (mother) when she tries to explain her answers to him when answering the interviewer. He does answer questions and interact with the interviewer but his answers aren’t accurate and he’s unable to explain his reasoning behind his answers. The answers he does provide to the interviewer seem to be relayed by his guardian as if he’s parroting the answers or as if they were practiced rather than him habing his own thought process of self-understanding. Unfortunately, his consent would have to come from his guardian.

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I think he can provide consent for physical procedures like asking him if it’s ok to do an extra oral exam and to touch his face, or look in his mouth, things like that. But when it comes to understanding benefits and risks it would be important for him to have someone there to help him, like his mom so he can be informed and depend on her to help him. He would need someone else present to provide consent. This would be important because Thomas may not be able to fully understand the procedures, including risks and benefits, therefore, he can't be properly informed to give consent. He seemed agreeable and like he wanted to please others. As a dental hygienist, I would not start treatment until his mom or trusted care provider was there to make sure everything was ok to proceed.

Rebecca Osborne

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Alexia Trakas - 200398869

After watching this short clip I don't think Thomas is able to provide consent on his own. I think this because he has a limited understanding due to his disability and was basically just agreeing with everything his caregiver or the other individual in the video was saying to him. In order to provide treatment you have to explain the risks and benefits and then gain informed consent. With that being said, I don't think Thomas is able to do that on his own unprompted.

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After watching the video, I believe Thomas does not have the capacity to provide consent to treatment on his own. It is evident that Thomas relies on his mother, by answering questions regarding Thomas's oral health needs, and recalling previous dental treatment. Down syndrome is an intellectual disability that can affect Thomas's ability to consent, as he may be unable to recall past information and dental treatment, may be unable to communicate his feelings and needs, and may not fully understand the risks/benefits of the treatment needed. In this case, the dental hygienist would relay the information, risk/benefits, and treatment to both Thomas and his mother, so they would both be able to consent and be informed/aware of the expected outcomes of the dental appointment. This collaboration allows Thomas and his mother to both be involved in the treatment.

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After watching the video, I do not believe that Thomas is able to consent to treatment on his own. Thomas is unable to fully understand the treatment being presented to him, this is shown through his looking at his mother for her to answer and after she does he then provides his input. Furthermore, it seems from the video that Thomas is continuously agreeing to the DH and not fully understanding what it all means and what he is agreeing to. This would explain why his mother is with him in the first place as she is likely his SDM. In this situation, it is important for the DH to understand the circumstances and address the needs of the client accordingly. This would include maintaining a professional demeanour while communicating with Thomas accordingly as well as including his mother in the discussion and treatment plan.

Madison Bumbacco

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I think that Thomas is not capable of consenting to treatment. During the video it showed that he mainly agreed but relied on his mom to answer the questions and he doesn't seem like he fully understood the questions or how to answer them on his own. I think that to obtain proper informed consent from Thomas, the mother should consent for him. I think that Thomas should still be included in the decision making process and the treatments should be explained to him in an easier way for him to understand by showing pictures, videos and simplifying the information so that he still feels included in what's going on. In the video he mainly just agreed with whatever was being asked but this could be an issue if he agrees to something he doesn't fully understand or want to happen. -Chelsea Farquharson

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After watching this video I think that Thomas is not capable of providing consent. It does show that Thomas has down syndrome which is a intellectual disability and as we learned to gain proper informed consent a Ct must be able to fully understand procedures/treatments. I do not believe that Thomas is capable of doing so. In the video Thomas refers to his mother about many things which demonstrates that he relies on her heavily. Thomas also seems like a very happy go lucky person, to keep the mood light and to make others happy Thomas may agree to things just to please others. Because of these reasons I do not believe he is capable of providing consent.

Shyla Ruth (200517293)

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I don't think Thomas is capable of providing consent for himself. He seems to not have the proper mental capability to make a proper decision on his own and he needs to be guided. He does not understand the concept of providing informed consent since he cannot make the difference between what is good or bad for him. He does not understand the treatment that is going to be provided to him and even though he expresses he wants his teeth cleaned is because he wants to please his parent. During the video, we are able to observe that his mother guides him in what he needs and that she is his main care giver and the one who makes the decisions for him since she is capable of rationalizing what is best for her child. It is important for dental hygienist to always have the main care provider during the appointments to ensure we are able to document that the procedure and treatment was explained and informed consent was granted before we are able to proceed with any treatment.

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Watching the video, and seeing Thomas interact with his mom and the questions that were asked, showed he is not capable of consenting to treatment on his own. His mother did most of the talking and when she did Thomas looked eager to agree with everything she was saying, this might mean he can say yes to anything without fully understanding what he does say yes too. He might just be saying yes to please others around him. Thomas's ability to understand and make informed decisions is at a diminished capacity, therefore his caregiver (mom) should be with him when consent is needed to ensure the safety and best interests of the individual. This is especially true due to the fact that the mother has stated Thomas needs to be aware of what is going to happen before the procedure takes place, and by involving his caregiver they can make sure Thomas understands, especially because it is coming from someone close to him whom he trusts.

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After watching the video clip and gathering the information about Thomas, I feel that based off this video Thomas is not capable of providing consent. I feel this way because it does show that Thomas presents with an intellectual disability. In order to gain informed consent, the client must be able to understand the information given to him about the treatment including why it is recommended to be done, risks, and benefits of the treatment. In this video, Thomas does not portray that he really understands what he wants to have done at his appointment and is looking to his caregiver to tell him what to say. In this case, it would be best to gain informed consent from his substitute decision-maker.

By: Brooke Bowman

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Based on the video clip, I think Thomas cannot give consent because he does not understand what consent means. I do not think Thomas understands the procedures for the treatment, and he just agrees while talking to him without fully understanding what they’re saying. It’s important that Thomas's mother is present in any treatment to give consent, and it should be explained to them both the risk and benefits, even if Thomas doesn’t have the capacity to understand and give consent for his treatments, but to make him feel included. When talking to a client like Thomas, a dental hygienist should make sure to use simple terms and visuals when explaining treatments.

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After watching the video of Thomas. I do not believe that he would be capable of giving consent on his own. As he was mainly agreeing to everything the dental hygienist was saying, but did not seem to fully understand what he was agreeing too. His care provider was seen answering and clarifying things for him. In this case his care provider would be considered the best option to receive consent in order to move forward with his treatment. Meaning the dental hygienist should explain the treatment proposed to both the care giver and Thomas, risk and benefits of treatment, the expected outcomes and evaluations, and letting them know treatment can be adjusted or modified at any given time.

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It appears that Thomas may not have the capacity to consent to treatment independently. In the video, his mother played a crucial role in reminding him of the necessary dental care. This suggests that Thomas relies on his mother's assistance to recall the treatment and that it was explained to him rather than him actively deciding on the care. Thomas knew and recalled that he wanted a dental cleaning. However, the rest he agreed to while his mother recollected him needing "permanent teeth". Some alternative communication methods we can employ are visual aids or simplified language to ensure Thomas can understand the information presented to him.

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While evaluating Thomas's ability to provide consent, it's essential to consider factors such as his understanding of the information presented, his ability to communicate his preferences clearly, and his awareness of the consequences of his decisions. In the case of Thomas, his limited verbal skills and understanding may hinder his ability to fully comprehend complex medical information or express his consent clearly. Additionally, his cognitive impairments associated with Down syndrome may impact his understanding of the risks and benefits involved in medical procedures or treatments. Therefore, based on the available information, Thomas may not have the capacity to provide informed consent independently. It's imperative for dental hygiene providers to engage with Thomas in a manner that respects his dignity and autonomy while also considering his unique communication and cognitive needs. Collaborating with his family or caregivers to ensure his best interests are upheld and that any decisions made align with his well-being is essential in such cases.

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I don't think Thomas is able to consent to treatment on his own. However, I feel that he should be included in the discussion of his treatment. Although he may not have the cognitive ability to fully understand the risks and benefits, we should still try and explain treatments and procedures to him so he knows what to expect. By including him in conversations, we can empower Thomas as an individual and make him feel like he is part of the process.

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I do not believe that Thomas is capable of providing consent. He seemed to have trouble recalling past information to do with his oral health and mostly relied on his mother to receive answers for what needed to be done for his oral appliance. He mostly agreed the entire video without fully showing his own understanding of what was being asked. This is troublesome in an appointment as he may agree to consent to procedures he does not understand and may struggle to ask for more information that's vital for making such choices.

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Based on this video clip, I do not think that Thomas is able to provide consent. This is because in order to give true informed consent, the client must fully understand the risks and benefits of each procedure. When asked what treatments Thomas would like done at the dental office, he looked to his mother for the answer, and then provided his feedback after her response. This tells me that Thomas might not have the capacity to provide consent. Therefore, receiving consent from a caregiver- such as his mother, would be a more appropriate option. However, it is important to include Thomas in this decision making process as each client is deserving of autonomy.

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I don't think he is able to consent on his own. He just may not fully understand the procedures, as mentioned he also may want to feel that sense of gratitude such as satisfying his mother or the clinician providing without fully understanding what is best for him. Having a parent there such as the mother to have a discussion with in regards to the treatment and consenting is preferable. - Adrianna Card

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I do not think that Thomas is able to consent to treatment on his own - Maybe with the help of his care giver (SDM) and clear explanation from the dental hygienist. Informed consent involves understanding the proposed treatment, risks and benefits, alternative options, and the ability to communicate preferences or concerns. Individuals with severe Down syndrome like Thomas may lack the cognitive capacity or communication skills to fully consent to proposed dental treatment