Ethics and Law Flashcards
(37 cards)
What is an advanced directive
written document when patient in sound mind for preferences when it comes to medical treatment should they become unable to express those wishes directly
All advanced directives are legal binding unless
The decision has been subsequently withdrawn
Power to make such decisions has been conferred to another person by creating a Lasting Power of Attorney
Since making the will the patient has acted in a way that is clearly inconsistent with the advance decision remaining their fixed decision
The person is not incapacitated and can decide for themselves
The treatment in question is not that specified in the advance decision
Any of the circumstances specified in the advance decision do not exist
There ‘are reasonable grounds for believing that circumstances exist which the person did not anticipate at the time of the advance decision and which would have affected his decision at the time of the advance decision.’
What does the AOMRC define death as
.the irreversible loss of the capacity for consciousness, combined with irreversible loss of the capacity to breathe
Certifying death requires a practioniner to check for
body temperature > 35ºC. In addition, the body must show no evidence of substance misuse or misadventure
and
No spontaneous movements.
No respiratory effort (examine for at least one minute).
No heart sounds or palpable pulses (examine for at least one minute).
No corneal reflex.
Pupils are fixed and dilated.
If CPR is attempted then
the individual should be observed for signs of life for a minimum of 5 minutes by the supervising clinician,
if DNA cpr then
confirmation of the absence of pupillary light reflex, corneal reflex and of any response to painful stimuli (usually the application of supraorbital pressure).
confirmation that there is no palpable central pulse and no heart sounds on auscultation for 2 minutes.
When can a nurse verify death
the death is expected and occurs a private residence, hospice, residential home, nursing home or hospital AND
a valid ‘Do not attempt cardio-pulmonary resuscitation’ document has been completed AND
there are no features that would prompt a referral to the local Coroner.
What are the 3 types of consent?
- Informed
- Expressed
- Implied
consent forms in the NHS
Consent Form 1 For competent adults who are able to consent for themselves where consciousness may be impaired (e.g. GA)
Consent Form 2 For an adult consenting on behalf of a child where consciousness is impaired
Consent Form 3 For an adult or child where consciousness is not impaired
Consent Form 4 For adults who lack capacity to provide informed consent
Capacity in a person is
decision and time specific
- Understand and retain information
- Patient believes the information to be true
- Patient is able to weigh the information to make a decision
All patients must be assumed to have capacity
Capacity in a person is
decision and time specific
- Understand and retain information
- Patient believes the information to be true
- Patient is able to weigh the information to make a decision
All patients must be assumed to have capacity
parents providing consent
biological mother always can provide consent
The childs father can consent if the parents are married (and the father is the biological father), or if the father is named on the birth certificate (irrespective of marital status).
a controlled drug prescription must have
name and address of the patient
the form, and where appropriate the strength, of the preparation
- either the total quantity (in both words and figures) of the preparation, or the number (in both words and figures) of dosage units to be supplied
the dose (cannot write ‘as directed’)
prescribers name, signature, address and current date
Duty of candour
All healthcare professionals must be honest when something has gone wrong. They must:
Tell the patient when something has gone wrong
Apologise to the patient (or carer or family member where appropriate)
Offer an appropriate resolution
Explain the potential short and long-term effects of the error
Accepting gifts as a doctor
‘You must not ask for or accept from patients, colleagues or others any inducement, gift or hospitality that may affect or be seen to affect the way you prescribe for, treat or refer patients or commission services for patients’
If a consutlant gives a job to the reg and he messes up is he at fault?
if delegating to a more junior doctor the consultant is not accountable for their decisions but are accountable to ensure that junior member is adequately trained and experienced to do the job
if a patient wants certain information not be shared but it is vital
If a patient objects to a disclosure, which is considered essential to the provision of safe care, you should explain that you cannot refer them or otherwise arrange for their treatment without also disclosing that information.
If a doctor thinks he himself is well
‘If you know or suspect that you have a serious condition that you could pass on to patients, or if your judgement or performance could be affected by a condition or its treatment, you must consult a suitably qualified colleague.’
‘You must follow their advice about any changes to your practice they consider necessary.’
‘You must not rely on your own assessment of the risk to patients.
What offences must the gmc be aware of
Are found guilty of a criminal offence
Are charged with a criminal offence
Formally admit to committing a criminal offence (for example, by accepting a caution)
Accept the option of paying a penalty notice for an ASBO
Receive a cannabis warning
Have had your registration restricted, or have been found guilty of an offence, by another medical or other professional regulatory body.
Your conduct (including as part of a management team) has directly contributed to an organisation that has entered into a deferred prosecution agreement.
teaching students
Thus we can conclude from this that both you and your colleague have a duty to teach the students. Thus allowing him not to teach or you also sending the students away will result in neither of you fulfilling your duty.
if a patient objects to anyone knowing whats the ruling
Most patients expect that some information will be shared with those who are directly involved in their care.
you should not disclose the information. The exceptions are: if it is justified for the public interest (as detailed below) or the patient lacks capacity.
You should explain to the patient the potential consequences of not allowing personal information to be shared and reach a compromise where possible.
In cases where a patient cannot be informed about information sharing, such as an emergency setting, you should pass relevant information to those providing the patient’s care.
in which circumstances can information be shared
You must be accessing the information to support the patient’s direct care, or be satisfied that it is being shared for that purpose.
Patients should be kept informed regarding how their personal information will be used. It should be clear that they have the right to object.
You must have no reason to believe the patient has objected to the information being shared.
You must be satisfied that anyone you disclose the information to understands that you are giving it to them in confidence.
sharing information to relatives
You should gain explicit consent.
When a patient lacks capacity, it may be necessary to share some relevant information with friends/ relatives. This does not entitle the person to full access to the patient’s clinical records
when must something be disclosed by law
Following an order made by a judge or presiding officer of a court.
In certain cases of communicable disease, when you must inform the local authority.
To prevent an act of terrorism.
To comply with a statutory request made by a regulatory body such as the GMC.
The police should usually be informed whenever a person presents with a gunshot wound, given the potential risk to others.
They should also be informed of most knife injuries- unless the injury appears to be accidental or a result of self-harm.
Personal information (such as the patient’s name and address) should not be disclosed in the initial contact with the police, and the police will respond even if the patient’s identity is not disclosed.
in order to assume a person has capacity they must be able to?
They must be able to understand the information surrounding a decision and its consequences
They must be able to retain the information long enough to make a decision
They must be able to use the information, by weighing up the pros and the cons of the decision
They must be able to communicate the decision
