ETHICS AND PROFESSIONALISM Flashcards

Question

What is an advance decision?

Answer 1

a statement of instructions about what medical and healthcare treatment you want to refuse in the future, in case you lose the capacity to make these decisions. It’s legally binding

Answer 2

You have the capacity to make those decisions now You're an adult (aged 18 or over) You can make your advance statement orally or in writing. If you want to refuse life-sustaining treatment, you must make it in writing

Answer 3

You will need to: Make your advance decision in writing Make it clear that you understand you are refusing life-saving treatment, and that you understand the consequences Include a statement confirming that your advance decision applies to life-saving treatment Sign your advance decision in front of a witness, and get them to sign it Include all relevant personal details, including your name and address

Answer 4

You cannot generally use an advance decision to refuse future mental health treatment that happens when you are sectioned under the Mental Health Act 1983. For example, you cannot refuse mental health medication in this way, in case you’re sectioned in the future. The exception is with electroconvulsive therapy (ECT). You can use an advance decision to refuse ECT in the future, even if you end up being sectioned.

Answer 5

A written statement setting down your preferences, wishes and beliefs regarding your future care It’s not legally bindings but it lets people know your wishes and preference if you lose capacity

Answer 6

Being deprived of liberty means that you’re not free to go anywhere without permission or close supervision. It also means that you’re continuously supervised. This is against the law unless it's done under the rules of the Mental Capacity Act. A deprivation of liberty should only be used if it’s the least restrictive way of keeping you safe. Or making sure that you have the right medical treatment.

Answer 7

Whether its in their best interest Whether its become necessary and unavoidable - i.e is it the least restrictive options

Answer 8

You’re age 18 or over You lack capacity to agree to the restrictions You’re staying in a care home or hospital, and they've successfully applied for an authorisation from the local authority The deprivation of liberty safeguards have been followed

Answer 9

The Court of Protection should be used to lawfully deprive you of your liberty if: You’re age 16 or over You lack capacity to agree to the restrictions You live at home, in supported accommodation or in a shared lives placement You’re in a care home or hospital but there’s a dispute over your placement there - DoLS can’t be used to take you aware from your home to a care home or hospital so you need an order from the Coiurt of Protection

Answer 10

DoLS dont need to have treatment for a mental health problem DoLS can be for keeping you safe or treating other health problems DoLS only apply to people who are deprived of their liberty in care homes, hospitals, and other medical facilities, and are not designed to apply to people who are detained under the MHA.

Answer 11

Liberty protection Safegaurds

Answer 12

The new system was intended to provide greater clarity around when and how restrictions on a person's liberty could be imposed, and to involve families and carers more closely in decision-making processes. The LPS were also intended to be more flexible than the DoLS, so that they could be applied to a wider range of care settings, including people's own homes.

Answer 13

a man with autism and learning disabilities who was detained at a hospital in 1997. He was not formally detained under the Mental Health Act 1983, but was deemed to be informally detained under the common law principle of "necessity" due to his inability to consent to his care and treatment. His family challenged his detention in court, arguing that his rights to liberty and autonomy had been violated. The case ultimately reached the European Court of Human Rights, which ruled in 2004 that HL's detention had been a violation of his human rights. This case highlighted a gap in the law regarding the deprivation of liberty of people who lack the capacity to consent to treatment - led to development of DoLS under the MCA

Answer 14

It goes against article 5 of the human rights act which is the right to liberty and security which should protect us from having our freedom taken away

Answer 15

Data protection Act 2018 Common law of confidentiality General data protection regulation Human rights act 1998

Answer 16

There are concerns that you’re at risk of serious harm or you’re in danger. There are concerns that someone else is at serious risk of harm or that they’re in danger. You’re unable to make the decision about sharing your information. Someone is told they have to by law.

Answer 17

Duty to protect third parties from harm Confidentiality Involuntary hospitalisation if they present a risk of violence to others - ethical concerns on autonomy (goes against article 5 of human rights) Use of restrains and seclusions - coercive measures and potential for abuse (also goes against article 3 of human rights) Use of medication - issues of consent and harms of SE

Answer 18

Review and discuss each patient's diagnosis and medical history, and agree on the best course of treatment for the individual. Consider the patient's physical, psychological, and social needs when developing a treatment plan. Identify any potential problems or barriers that may affect the patient's treatment, such as side effects, risk of infection, or other complications. Develop an ongoing care plan that may involve follow-up appointments, ongoing monitoring, and rehabilitation services.

Answer 19

Clear communication Clearly defined roles and responsibilities Collaborate approach to decision making Access to appropriate resources Meeting regularly Respect each other

Answer 20

Lack of communication: Poor communication between team members can result in misunderstandings and poor decision-making. Role confusion: If team members do not understand their roles and responsibilities, this can lead to duplication of effort or gaps in care provision. Resource constraints: Limited access to resources, such as diagnostic tests or treatment options, can limit the MDT's ability to provide the best care possible. Conflicting priorities: Team members may have different priorities, making it challenging to agree on the best course of action. Uneven workload

Answer 21

patients receive comprehensive and coordinated care that addresses all their medical, physical, emotional, and social needs. It helps to avoid fragmented care Avoids duplication of services It allows better use of resources Increases pt satisfaction

Answer 22

a legal document issued by a medical practitioner which states when a person died, or a document issued by a government civil registration office, that declares the date, location and cause of a person's death

Answer 23

Enables deceaseds family to register the death Permenant legal record of the death Enables family to arrange disposal of the body and settle the deceased’s estate

Answer 24

Within 5 days of their occurrence unless there is to be a coroner’s postmortem or an inquest

Answer 25

the statutory duty of the doctor who has attended in the last illness to issue the MCCD

Answer 26

The death was due to poisoning including by an otherwise benign substance The death was due to exposure to, or contact with a toxic substance The death was due to the use of a medicinal product, the use of a controlled drug or psychoactive substance The death was due to violence, trauma or injury The death was due to self-harm The death was due to neglect, including self-neglect The death was due to a person undergoing any treatment or procedure of a medical or similar nature The death was due to an injury or disease attributable to any employment held by the person during the person's lifetime The person's death was unnatural but does not fall within any of the above circumstances The cause of death is unknown The registered medical practitioner suspects that the person died while in custody or otherwise in state detention The attending medical practitioner is not available within a reasonable time of the person's death to sign the certificate of cause of death The identity of the deceased person is unknown (Basically the only way that you do not is it you know what illness caused the patient's death and have seen and treated them for that illness within the 28 days before they died)

Answer 27

Autonomy Beneficence Non-maleficience Justice

Answer 28

The individual freely acts in accordance with a self-chosen plan The ethical duty is to ensure patient’s decisions are informed and voluntary

Answer 29

The moral obligation of a doctor to act in the best interest of the pt and promote good for society

Answer 30

An ethical duty to avoid harming or injuring the pt

Answer 31

a doctor is not guilty of negligence if he has acted in accordance with a practice accepted as proper by a reasonable body of medical men skilled in that particular art I.e. you have to show that any medical professional who was in the same position as them would have done the same, giving the same outcome

Answer 32

All patients are treated fairly (with equity)

Answer 33

A breach in the legal duty of care which results in damage

Answer 34

Bolam principle

Answer 35

An adaptation of the bolam principle - it builds on the Bolam test by introducing an additional requirement that the medical opinion relied on by the defendant must be capable of withstanding logical scrutiny

Answer 36

In this scenario, the triage nurse did not refer a patient with symptoms of a heart attack to a doctor, and the patient suffered a heart attack later. The nurse may be found negligent under the Bolam principle if it is determined that a reasonable body of medical professionals would have referred the patient to a doctor in the circumstances. If the Bolitho test is applied, the nurse may still be found negligent even if they can demonstrate that their actions were in line with accepted medical practice, if it is determined that their medical reasoning was flawed or did not withstand logical scrutiny.

Answer 37

that branch of moral philosophy, or ethics, concerned with criteria of what is morally right and wrong

Answer 38

Virtue ethics Deontological ethics Consequentialist ethics

Answer 39

An action is only right if it is an action that a virtuous person would carry out in the same circumstances

Answer 40

An ethical theory that states it is possible to determine the rightness or wrongness of actions by examining actions themselves without focussing on the consequencues

Answer 41

An ethical theory that it is possible Tod determine the rightness or wrongness of actions by examining its consequences I.e. an action that brings more good is better

Answer 42

the right thing to do in any situation is whatever will “do the most good” (that is, produce the best outcomes) taking into consideration the interests of all concerned parties;

Answer 43

The legal term used to describe the ability of a child or youn g person under 16 to make decisions about their own medical treatment, without the involvement of parents/guardians, if they are deemed to be mature and capable of understanding (i.e. if they are competent) They can accept treatment but cannot refuse treatment! Once over 16 they are assumed competent unless proven otherwise and can accept and refuse treatment

Answer 44

individuals should be free to act as they please, as long as their actions do not cause harm to others. The only purpose for which power can be rightfully exercised over a person against their will is to prevent harm to others

Answer 45

Harm principle support vaccines being compulsory - decreases risk of disease transmission to vulnerable populations

Answer 46

they must understand all the professionals advice They must not be persuaded to inform their parents They will likely begin or continue having, sexual intercourse with or without contraceptive treatment Unless they receive contraceptive treatment their physical or mental health are likely to suffer Their best interests require them to recieve contraceptive advice or treatment with or without parental consent

Answer 47

Cannot apply Fraser guidelines as under 13 You should inform the parents/social services/police as this is statutory rape and pt cannot consent at this age

Answer 48

Court of Protection They can make decisions on behalf of individuals who lack capacity, including decisions about medical treatment, such as sterilization. If a healthcare professional believes that sterilization may be in the best interests of a person who lacks capacity, they can make an application to the Court of Protection for a decision to be made.

Answer 49

UK law that aimed to protect people with disabilities from discrimination in a wide range of areas, including employment, education, and access to goods and services. The act made it illegal for employers, service providers, and educational institutions to discriminate against people with disabilities, and required them to make reasonable adjustments to ensure that people with disabilities were not put at a disadvantage. E.g. allowing someone with anxiety to have their own desk, reasonable adjustment during recruitment, installing ramps for wheel-chair access, letting disabled persons work on ground floor, allow flexible hours

Answer 50

a fundamental ethical principle that pertains to fairness and impartiality. In healthcare, the principle of equity means that all patients should be given access to the same quality of care and should not be discriminated against based on factors such as race, gender, age, socioeconomic status, or health condition.

Answer 51

a fundamental ethical principle that is concerned with promoting the greatest good for the greatest number of people. Also known as the principle of consequentialism or the greatest happiness principle, this principle suggests that actions or decisions should be made based on their ability to maximize overall happiness and well-being.

Answer 52

fair distribution of resources and benefits within a society or healthcare system. Both principles aim to ensure that everyone has an equal opportunity to access healthcare services and receive the care they need.

Answer 53

It can be difficult to measure or define "happiness" or "well-being" in a way that is objective and applicable to all situations. it can lead to decisions that are not equitable or just, as it may prioritize the interests of the majority over the needs of minority groups. Lack of consideration for other important ethical principles

Answer 54

Deontological theories of morality emphasize the importance of following moral rules or duties. These theories argue that certain actions are inherently right or wrong, regardless of their consequences

Answer 55

Need to respect confidentiality - ensure information is shared appropriately between those involved in the care Working in pt best interests Decision-making capacity Autonomy

Answer 56

Practical challenges of working within systems of care Communication difficulties which make it hard for the MDT to understand their needs and preferences Behaviour changes may be difficult for MDT to manage Including the wishes and needs of others such as carers Ethical challenges e.g. respecting confidentiality Challenges regarding responsibility and decision making Concern over elder abuse Risk assessment

Answer 57

Increased risk of falls and injuries due to agitation/wandering - remove tripping hazards, provide adequate lighting, develop a plan to ,on it or behaviour Diffiuclt with ADLs - visual aids, social support Increased risk of social isolation as harder to engage in social activities - group activities or one-on-one visits with staff members Increased caregiver stress

Answer 58

Difficulty in remembering to take medications or managing medication schedules - dossette box, clear instructions to caregivers Difficulty in communicating side effects or adverse reactions to medications - leaflets, educate caregivers about potential side effects Increased risk of medication errors due to impaired cognition Difficulty in administering medications (such as injections) due to behavioral changes - - use alternative medication delivery methods e.g. transdermal patch

Answer 59

Patients with advanced dementia may have limited life expectancy and may require palliative care or hospice care. A multidisciplinary team should consider the patient's wishes and goals of care, as well as the family's wishes and cultural beliefs. The team should consider the patient's physical and emotional comfort, and ensure that the patient receives appropriate pain management and symptom relief. The team should provide support to the patient and their family during the end-of-life process, and facilitate discussions about advanced care planning and decision-making.

Answer 60

Difficulty understanding the pt’s needs and preferences if they have difficult expressing these - use a range of communication startegies e,g. Visual aids Difficulty conveying information to the pt - simple language, repetition, visual aids Difficult building rapport which can impact the quality of care provided - active listening skills, non-verbal communication and empathy Difficulty involving the pt in decision making - impacts autonomy - involve family members or caregivers

Answer 61

Valid/informed consent Principle of best interest Duty of care - HCP must ensure they are providing safe and effective care that meets pt needs. This includes managing challenging behaviour in a way that minimises harm and promotes positive outcomes for pt Human rights law article 3 prohibits inhumane and degrading treatment - use of restrains may go against this unless alternative methods have been explored first Human rights law article 5 - right to liberty Coercion and force - violates human rights and may be considered abuse Ethics - breaches their autonomy but may be beneficient/maleficient Legal responsibility of a HCP is to report incidents of abuse and neglect Legal - minimum level of force for the least amount of time needed Justification for use must be to prevent injury to oneself or to others, or to prevent serious damage to property Ethics - imbalance of power Section 6 of the mental capacity act defines restraint and says its only permitted if the person using it reasonably beehives its necessary to prevent harm and if the restrain used is proportionate to the likelihood and seriousness of that harm

Answer 62

An act carried out with the purpose of restricting an individual’s movement, liberty and/or freedom to act independently

Answer 63

Beneficence - treatment will mitigate symptoms of illness which are severe enough to harm them or others Reduces their autonomy MHA - legal Is it the least restrictive option? Pt must ahve the right to a fair trial, right to legal representation, right to an IMHA etc

Answer 64

Autonomy - violation Ethical - may have a significant psychological impact e.g. exacerbating feelings of guilt which can complicate their progress Medical risks e.g. aspiration pneumonia, refeeding syndrome Mist be the least restrictive option Does the pt have capacity Is it in their best interests? Mental health act

ETHICS AND PROFESSIONALISM Flashcards

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