Case 10- alcoholism and confidentiality Flashcards Preview

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Flashcards in Case 10- alcoholism and confidentiality Deck (33)
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1
Q

Health consequences of recreational alcohol use

A
  • Stroke
  • Brain damage
  • Withdrawal symptoms
  • Depression, anxiety, suicide
  • Cancer of mouth, throat, oesophagus, larynx
  • Heart disease
  • Harm to unborn baby
  • Liver disease and cancer
2
Q

Impact of drug and alcohol misuse on families

A

Parental alcohol and drug dependence significantly harms the wellbeing of children
Drug and alcohol misuse can be part of a complex set of coexisting health and social problems
Misuse can impact on health&wellbeing, education, risky behaviours and result in inappropriate caring roles

3
Q

Drug and alcohol misuse effect on communities

A

communities

  • 40% of victims of violence believed perpetrators to be under the influence of alcohol
  • 48% of domestic abuse perpetrators had a history of alcohol dependance, 73% had been under influence of alcohol prior to event
  • Alcohol and drug problems are both a cause and a symptom of homelessness
  • Alcohol misuse also causes a loss of £7bn in work productivity
4
Q

Health consequences of drug use

A

STI’s, depression, cardiovascular disease, lung damage, blood born virus’s and bacterial infections

5
Q

Effect of alcohol use on spending

A

Loss productivity, More money has to be spent on crime, policing and the NHS

6
Q

How the doctor can help someone with alcohol dependence

A

They can offer help and information to the patient as well as referring them to specialist service’s. The GP should review drug and alcohol use at each session and understand local need.

7
Q

Alcohol and baby development

A

Alcohol can effect foetal development resulting in foetal alcohol spectrum disorder (FASD). This may cause the baby to have an abnormal appearance, low body weight, poor co-ordination, low intelligence, behavioural problems and problems with hearing or seeing. The most severe form of the condition is foetal alcohol syndrome (FAS) where children have restricted growth, facial abnormalities and learning and behavioural disorders.

8
Q

Summary care records (SCR)

A

An electronic record of important patient information created from GP medical records. It is created automatically when you join a GP service but it is important to check that the patient consents to this. This record is shared across the NHS.

9
Q

National data opt out

A

You can choose for your confidential patient information to not be used for purposes other then your own care and treatment

10
Q

How to legally protect patient information

A

Keep it secure
Ensure it is relevant and up to date
Only collect information you need for a specific purpose
Only hold as much as you need, for only as long as you need
Allow the subject to see the information upon request

11
Q

Legal aspects about the storage and use of electronic patient information

A

Data protection act 2018 - certain info should be provided to patients
Human Rights Act 1998 - no personal information should be stored in regards to private life, unless necessary

General Data Protection Regulation 2016:
Personal data should be collected for legitimate purposes
It should be accurate and up to date
It should be processed lawfully
Shouldn't be kept for longer than needed
12
Q

GDPR lawful bases for processing electronic patient information

A

One of these must apply at least, when processing personal data:

1) Consent
2) Contract - processing is necessary for a contract signed with the patient
3) Legal obligation - processing is necessary to comply with the law
4) Vital interests - processing is necessary to save / improve a life
5) Public task - processing is necessary to perform a task in public interest
6) Legitimate interest

13
Q

Problems with the storage and use of patient information

A

Large studies involving lots of patients make it hard to obtain informed consent from all of them. Some patients cant give consent but we still need their information

14
Q

Dual responsibilities in confidentiality

A

1) Occupational health
2) Insurance companies
3) Benefits claims
4) Prison services

15
Q

GMC’s 8 principles of confidential information

A

1) Use the minimum information necessary
2) Manage and protect information
3) Be aware of your responsibilities
4) Comply with the law
5) Share relevant information for direct care
6) Ask for explicit consent to disclose information
7) Tell patients about disclosures
8) Support the patients right to access their own information

16
Q

The DGPR’s ethical right’s for processing data

A
  • The right to be informed
  • The right of access
  • The right to rectification
  • The right to erasure
  • The right to data portability
  • The right to object
  • The right to restrict
17
Q

Negatives of patient support groups

A
  • May be run by organisations who don’t have the best interest of the patient.
  • Strategies may not be evidence based.
  • Medical information shared on forums may be incorrect.
18
Q

The ethical basis for confidentiality

A

1) Patients best interest)
2) Privacy rights
3) Personal integrity
4) Doctor-patient trust

19
Q

The professional basis for confidentiality

A

GMC guidance states anonymise data when possible, keep disclosures to the minimum necessary and seek patient consent for disclosure when possible

20
Q

The legal basis to break confidentiality

A

Judicial proceedings
Regulations e.g. infectious diseases
Information might be needed to support essential NHS activity

21
Q

Justified breaches of patient confidentiality

A

1) When the patient consents to disclosure
2) When disclosure is of overall benefit to the patient who cant consent
3) Disclosure is required by law
4) Disclosure can be justified in the public interest

22
Q

Benefits of patient support groups

A

Patients gain insight on their condition, feeling more in control and empowered. Saves the NHS money through reduced appointments and the patients gain self-coping strategies and support.

23
Q

What patient support groups provide?

A
  • Education- information and an understanding about the condition, symptoms and management.
  • Advice- on lifestyle and condition management. The advice can come from people with the condition or healthcare professionals
  • Discussion forums- you meet people all over the world, provides support out of hours
  • Role models
  • Activities- you can meet people in support groups providing individuals with a distraction, social interaction and an opportunity to make friends
  • Awareness – support groups can be linked to charities, they can run fundraisers and spread awareness of conditions.
  • Group therapy.
24
Q

Why it is important for medical professionals to value diversity?

A

1) Improves patient care- more likely to open up if they feel respected
2) Increases job satisfaction
3) Learn from peoples differences
4) Maintains trust between patients and colleagues
5) Make sure you are acting with honesty and integrity

25
Q

How racial harassment can effect someone’s career?

A
  • Excluding ethnic minority staff from decision making
  • Allocating work beneath their ability
  • Blocking opportunities for learning and development
  • Withholding credit for their ideas.
26
Q

Active bystanding

A

When viewing racial discrimination, it is important to report what you see. By leaving it to BAME students you can exacerbate their isolation

27
Q

Legal framework for respecting diversity

A
  • Duty of care law- duty to try to avoid inflicting harm
  • Contract law: breach of contract- students and staff may have made agreements about (un)acceptable behaviour
  • Protection from Harassment Act 1997
  • Human Rights Act 1998, particularly acts 9 and 10 (‘freedom of expression’)- able to express religious beliefs within the limit of the law and public safety.
  • Defamation Act 2013 (limits ‘freedom of expression’)
  • Equality Act 2010- allowing for equal opportunity between people with a protected characteristic and does who don’t. Reduce discrimination and harassment.
28
Q

Protected characteristics

A

Age, disability, gender reassignment, pregnancy and maternity, race, religion or belief, sex, sexual orientation.

29
Q

Harassment

A

It is unwanted conduct due to a protected characteristic made to violate their dignity or create a hostile, degrading or humilitating environment.

30
Q

Ethical issues associated with organ transplant

A

• Who gets the organ?
• Relatives only get approached once death is confirmed - how is death defined, brain dead or when the heart stops?
• Coercion of living donors
• Lack of ability allow for the individual to give consent e.g. brain dead
• Issues with religious beliefs
Should the NHS pay donors?

31
Q

Legal issues with organ transplant

A
  • Families can object even if the person signed the donor register.
  • Opt out systems- people may not be aware. Made law in the Organ donation act 2019. Children and adults who lived outside the UK and adults who lacked capacity for a while before their death are excepted.
  • Human tissue act 2004- specifies consent must be given before organ transplantation occurs. Human organs can not be sold or bought.
  • Nominated representatives can make known the wishes of the patient
32
Q

An individual’s personal responsibility for health

A

1) It may not be easy to determine to what extent personal decisions are influenced by socio-economic factors beyond one’s personal control. For example, someone who is richer will be able to afford more healthy food.
2) People engage in health impairing behaviours that damage their own organs. Therefore should they be trusted with getting someone else’s?

33
Q

What factors may be morally relevant with organ donation?

A
  • Age
  • Should it matter whether the individual has opted out of the donor register
  • Social status and value for society
  • Personal choices that contributed to the liver disease
  • Length of time on the waiting list
  • Urgency of treatment
  • Likelihood of positive outcome
  • QALY