ethics Flashcards
Autopsy: Hospital/consented - MCCD issued
To determine extent of disease, response to treatment, occult disease
To support teaching/training/research/audit
article 1
right to life 🡪 everyone’s life shall be protected by law
Withdrawal of futile treatment will not breach article 2
Does not include fetuses
article 3
prohibition of torture
article 5
right to liberty
Detention is lawful if necessary for a mental illness
Individuals must have access to an effective, speedy means of challenging detention 🡪 MHA appeal process, DoLS
article 8
right to a private life
Confidentiality
Can refuse medical treatment even if life-saving
The Universal Declaration of Human Rights 1948: Article 25
Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services
Refer to coroner if
Cause unknown, not seen by a doctor during illness/last 14 days, uduring or within 12 months of pregnancy, death in custody, while detained under Mental Health Act
Death due to suicide, accident, trauma, industrial, medical/surgical treatment, abortion, anaesthetic care, lack of medical care, murder, self neglect
death certificate 1a =
1a - ultimate cause of death e.g. bronchopneumonia
death certificate 1b
1b causes 1a e.g. lung cancer
death certificate 1c
1c causes 1b
death certificate part II
Part II - other diseases related to cause of death but not related to 1a-c e.g. diabetes mellitus for a patient who died of MI
medicolegal autopsy (most)
MCCD cannot be issued
types of medicolegal autopsy
forensic and coroner or Death violent/unnatural/cause unknown/died in prison, police custody or another type of state detention
forensic medicolegal autopsy
Coroner’s rules
Forensic pathologist
Police involvement
coroner medicolegal autopsy
Coroner’s rules
General pathologist
Homeless guy dies (sign of trauma), cannot contact next of kin
Can still do CORONER’S AUTOPSY as this is suspicious death and coroner’s autopsy does not require permission
Would not be able to do a HOSPITAL AUTOPSY without any next of kin consent
HIV +ve girl dies of cerebral toxoplasmosis, before she dies she says she doesn’t want to disclose her HIV status. What do you write on the death certificate?
Include HIV in death certificate 🡪 MUST COMPLETE DEATH CERTIFICATES HONESTLY AND FULLY even those confidentiality continues after patient death
In reality would get advice from MDU et
45 year old woman with learning difficulties and cerebral palsy, gets influenza, then Strep pneum, then dies of cardiorespiratory arrest. Fill out death certificate
1a: Strep pneumonia
1b: Influenza
2: Cerebral palsy/Learning difficulties?
Man dies, daughter consents to autopsy, step-mum (his wife) does not want autopsy. What to do?
Must abide by wife’s decision as she is top of hierarchy of qualifying relationship 🡪 NO AUTOPSY
Man with brain mets from lung cancer, history of PE, dies of cardiorespiratory arrest. Fill out death certificate
1a: PE?
1b: Lung cancer?
2: Brain mets?
Woman found at home surrounded by needles, lots of extra pathologies - PE, etc. Family are waiting for the death certificate what do you do?
Refer to coroner as cause of death is unknown?
Hospital autopsy. Coroner wants a spine specimen for teaching. What do you do?
Check if person themselves gave permission 🡪 cannot use for teaching without their own consent
Dad and brother of dead individual disagree over having an autopsy. The Dad was the main carer but no mention of Standing order or special status assigned to dad by the dead individual.
Dad is above brother 🡪 dads choice goes
If they were equal hierarchy 🡪 law says that technically only consent from one of these is needed for autopsy
But must handle this ‘sensitively and discuss with all parties’
