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Reproduction > Ethics > Flashcards

Ethics Flashcards

1
Q

when is sex selection of embryos permitted in UK

A

for medical conditions that are linked to a gender

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2
Q

why would you create an embryo with 2 genetic mothers

A

to avoid mitochondrial diseases

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3
Q

when can you refuse assisted reproduction treatment

A

issues with child welfare
reduced success rate (older female age etc)
increased risk of harm (obesity and smoking)
when it is not legal (e.g. sex selection not for medical conditions)

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4
Q

how many cycles of IVF is funded on NHS in scotland

A

3

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5
Q

how many IVF cycles is funded in patients aged 40-42

A

1

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6
Q

how long is embryological research permitted for

A

14 days (when primitive stream appears)

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7
Q

how late can you get an abortion

A

24 weeks

later if severely handicapped or significant risk to maternal life

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8
Q

what are the rights of donors of genetic materials

A

to choose the outcome of their genetic material

to be anonymous

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9
Q

is egg donation legal

A

yes

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10
Q

does the child have a right to find out biological origins

A

yes at age 18

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11
Q

does sexual consent have to be informed

A

no- can be free agreement

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12
Q

can a child under 13 consent to any sexual activity

A

no- if you are told this by child need to inform social services

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13
Q

can an older child ages 13-15 legally have sexual intercourse

A

no

but consensual touching, kissing and sexual conversations are considered part if growing up

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14
Q

when can you provide contraception for a child under 16

A

when you have assessed that the child is:

  • fully competent
  • has sufficient maturity and intelligence to understand the implications
  • has not been persuaded
  • is likely to continue sexual activity without the contraception
  • if their physical or mental health will suffer without the contraception/ advice
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15
Q

when is a person over 16 not considered able to consent to sexual decisions

A

if lack capacity (e.g. mental disorder)
or other person is in a position of trust (teacher, family member etc)

in incapable then will need advocate to make decisions for them (adults with incapacity act)

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16
Q

when would you perform a genital exam on a child/ someone who is not sexually active/ doesn’t have consent

A

always ask a senior before hand
never do smear or vaginal exam on someone who is not sexually active unless symptomatic or extenuating circumstances- again always ask someone first and have chaperone
seek consent from a responsible person, unless emergency

17
Q

what are the only times you can treat an adult (16+) without their consent

A

If is an emergency (real emergency, not just in A&E)
You can apply the Adults with Incapacity Act (form)
You can apply the Mental Health (Scotland) Act

18
Q

what is battery

A

unlawful touching

  • could apple if you act without a patient’s valid consent
  • person may need not be harmed by procedure
19
Q

how is consent different from a contract

A

consent can be withdrawn at anytime without penalties, this removal of consent should be respected immediately, not binding (getting valid consent is a continuous process)

contract- withdrawing can have consequences, it is binding

20
Q

can a patient refuse/ demand any treatments

A

can refuse any (inc life saving)

cannot demand treatment

21
Q 
in competent patients who refuse Tx, does their reasoning have to be:
Logical
Prudent
Rational
Reflected
Justified
Communicated
Discussed
Correct according to you or your colleagues
?
A

no

22
Q

how can you improve someones capacity to consent

A

discuss anxieties, fear of pain/ other problems
written maternal, pictures, other aids
meet communications needs
use clear simple language
suggest they bring a friend/ relative/ translator
give them opportunities and time to ask questions and answer honestly- capacity may change over time
give time to reflect on their decisions (give consent forms and information in advance)

23
Q

what is included in assessment of capacity

A

check patient can:
1. Understand the treatment options and weight up potential benefits, risks, burdens and side effects of the options

  1. Retain the information provided
  2. Weigh up, decide and communicate their decision
24
Q

what is required for valid consent

A

capacity (competence)- ability to give/ withdraw consent
information- enough information and it is understood (both parties ask questions to ensure this)
voluntariness- not coerced

25
Q

what are the rule in an emergency

A

If the treatment is immediately necessary to save a someone’s life or to prevent a serious deterioration:

  • You can treat people without their consent
  • The treatment must be the least restrictive of the patient’s future choices
26
Q

can you assume someone is incapable of consent

A

no- in adults capacity is assumed until proven other wise

27
Q

should you inform patient of all options available to them

A

yes

28
Q

what should you do if there is uncertainty/ disagreement between yourself and colleagues/ patient/ patients family

A

Consult it with other colleagues
Ask more senior colleague for advice
Ask for second opinion
Consider mediation or involving an independent advisor
Contact your defence organisation (e.g. Medical Defence Union)
Ask your professional body
Find out if there is a Clinical Ethics Committee
Seek legal advice
Apply for independent court/statutory ruling

29
Q

what are the rules of treatment of children

A

Parent/s (or legal guardian/s) must be consulted about their child’s treatment (unless it is an absolute emergency)
It is assumed that parents make decisions in the best interest of their child, and must be consulted from the moment of birth
Child’s consent should ideally also be sought, even from toddlers
However, the State must protect the best interests of the child, so can override parents’ (guardians’) wishes
The power can be devolved to others – e.g. doctors, nurses, social workers etc.

30
Q

what is the most recent guidlines on treatment of children

A

Children and Young People (Scotland) Act 2014

31
Q

what happens if parents disagree with the healthcare team

A

Judge (courts) can assess the situation and override parents’ refusal of consent

In urgent situation this can be dealt with over the phone in a matter of hours

32
Q

who has parental responsibility

A

Births registered from 4 May 2006 in Scotland: PR rests with both parents, if they are named on the birth certificate, whether married or not.

Births registered before 4 May 2006 in Scotland: father automatically has PR only if he was married to the mother. If not, he needs a Parental Responsibility Agreement/Order. A step-parent or civil partner may also obtain PR in this way.

If parents divorce, both retain PR for the child, no matter who the child lives with or spends most of his/her time with.

PR is lost by giving the child up for adoption. When the child has been formally adopted, the adoptive parents get PR.

33
Q

can people under 16 consent

A

yes if assessed to have capacity

34
Q

when can you disclose personal information

A

if the patient consents to this
if it is required by law in the public interest (infectious disease, risk of death/ serious harm/ serious crime- murder but not left)

35
Q

can police, solicitor, employer, school, relatives, insurance company get a patients information

A

have to have a judicial order or by required by an act of parliament

36
Q

what are the rules of patient information that is released

A

All released information should be protected, anonymised or coded
People should be NOT IDENTIFIED, but also NOT INDENTIFIABLE

People have the right to be informed about all disclosures (unless it would cause serious risks, e.g. in cases of serious abuse or child neglect)

37
Q

when can information be shared with family

A

If a person below the age of 16 is assessed as having capacity to consent to certain treatment, then the information about this treatment cannot be disclosed to his/her parents without her/his explicit consent

If an adult patient has no or limited capacity (e.g. is in a coma or detained under the Mental Health Scotland Act) then certain information can be released to nearest relatives, friends or others – but the rules can be complex

38
Q

what should you do if a patient is no longer fit to drive

A

inform her/him of a legal duty to inform the DVLA or DVA about the condition
If s/he continues to drive when they may not be fit to do so, you should make every reasonable effort to persuade them to stop
If you discover that they are continuing to drive against your advice, you should contact the DVLA or DVA immediately and disclose any relevant medical information to the medical adviser
You should then also inform the patient immediately as well as in writing once you have done so

Reproduction (51 decks)

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