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TOK legal and ethical Flashcards

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1
Q

Who has responsibility for explaining the risks of a general

anaesthetic for dental treatment to a patient or parent?

A

The Hospital/ Community Dentist who assesses the patient. The referring GDP. The treating dentist.

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2
Q

In which of the following treatment scenarios for an adult patient, is it inappropriate to delay treatment, if consent could not be attained?

A

Post extraction bleeding. Marked facial swelling or where airway may be compromised.

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2
Q

Your patient has recently appointed her husband and son

as joint welfare attorneys. As her dentist, how should you

decide whose views you must consider when the patient

cannot consent to treatment by herself

A

You should refer to the patient’s individual POA document for specific instructions

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2
Q

Your patient, a nine year old boy, requires an extraction

but is not in pain. He is accompanied by an adult relative

who does not have parental responsibility. To follow legal

best practice, how should you proceed?

A

Delay treatment until parental consent is obtained.

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3
Q

A patient attends with a broken down upper central

incisor. The dentist decides that a crown will be required

to restore the tooth.Which of the following are required

for effective valid consent?

A

Patient given indication of the likely cost of treatment Specific warnings as to risk

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4
Q

While chatting to a patient, your nurse asks if her

husband’s new dentures are still giving him problems. Is

this?

A

A breach of confidentiality

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5
Q

Which of the following are defined as protected

characteristics, according to the Equality Act 2010?

A

Gender Sexual orientation Race

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6
Q

The practice has a policy allowing for time off to attend

medical appointments. The VDP requires to attend a

number of appointments in relation to their gender

reassignment, but is refused This is an example of?

A

Discrimination

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6
Q

Under the Data Protection Act 2018, which of the

following may be found liable for a breach of

confidentiality in relation to the inappropriate disclosure

of a patient’s records?

A

Dental hygienist Dentist Dental receptionist Dental nurse

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7
Q

Written consent is always required for?

A

Treatment under GA

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7
Q

‘Specific’ consent for GA extractions should be obtained:

A

On the day of GA prior to procedure By GDP prior to referral for GA

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7
Q

Any proposed treatment should always be discussed fully

with the patient to ensure that informed consent is

obtained. In addition, the GDC advises that written

consent should also be obtained for which of the following

procedures?

A

NHS treatment under inhalation sedation NHS treatment under IV sedation Private treatment under IV sedation NHS treatment under general anaesthetic Private treatment under general anaesthetic

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8
Q

When obtaining treatment consent for a child who is

incapable of providing consent themselves, consent can be

given by whom?

A

A Step-Father with a parental responsibility agreement A child’s mother

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9
Q

According to the GDC Standards on Consent, which of the

following are “things that patients might want to know”

before consenting to treatment:

A

The cost of proposed treatment The likely prognosis Options for treatment, their risks and potential benefits Whether the treatment is guaranteed, how long it is guaranteed for and any exclusions that apply

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9
Q

Under the Equality Act 2010, age is protected

characteristic only for those over 75

A

False

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10
Q

Under what circumstances is a dentist LEGALLY required to

disclose patients’ personal information to the police?

A

If the police have a court order

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11
Q

A patient you have known for a while and trust suggests

that his marketing firm could increase your profitability by your supplying him with your patient list to do telephone sales of your sundries, toothbrushes etc. Should you?:

A

Explain you have to keep patients records secure and decline

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12
Q

Which of the following is true in relation to consent?

A

What the patient wants to know about their plan should be taken into account The cost of treatment should usually be discussed When obtaining consent, it is legitimate to explain your recommended treatment option

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12
Q

According to ICO guidance, how often should Privacy

Policies be updated

A

Regularly

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13
Q

For computerised patient records, which of the following

are true in relation to the Data Protection Act?:

A

It is a criminal offence to process personal information without being registered with the Information Commissioner. Data must not be disclosed to third parties without prior consent. All staff must be aware of the need for strict confidentiality

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14
Q

To save time you have decided to delegate obtaining

consent to your nurse. In which of the following situation

is this allowable?

A

Never

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15
Q

You are treating a carious tooth on the NHS and consent

has previously been obtained for an amalgam restoration

only. A large carious exposure becomes apparent during

treatment. Which of the following would be appropriate in

relation to consent?:

A

Tailoring the way you obtain consent to the individual patient’s needs Fully documenting the discussions which took place which led to the patient’s decision Explaining your recommended option Discussing the cost of the various treatment options

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16
Q

Which of the following patient information is considered

personal and therefore subject to GDC guidelines

pertaining to confidentiality?

A

Non-payment of fees/account history Appointment times/attendances Name/Address/Registration with practice Pervious Dental History

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16
Q

After transferring records to accurate microfiche you wish

to dispose of a large number of expired record cards. To

comply with legislation which are the acceptable methods

of disposal?

A

Shredded as part of office waste

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17
You place an advert on-line for a new trainee dental nurse (male or female) to join a progressive, young and dynamic team. This would be discriminatory on the grounds of
Age
18
Mrs Tsang attends his dentist, a visit instigated by his wife Mrs Tsang. Mrs Tsang is embarrassed that her husband is not tolerating his lower denture and would like the dentist to make a new denture. As a POA for Finance and Welfare, Miriam’s responsibilities do not entitle her to:
Demand the treatment that she feels he needs is carried out.
18
A regular patient, who is booked in for an examination, enters your surgery and sits down on the dental chair. By doing this, the patient is consenting to:
A dental examination.
19
The maximum duration for a certificate of incapacity is:
3 years depending on the nature of the illness.
20
What is ‘’Duty of Candour’’?
Discussion of adverse incidents involving the patient.
21
If a duty of candour incident occurs, the procedure to be followed
Includes notifying the person affected and offering to meet to give an account of what happened Must be carried out by the responsible person Is outlined in the Duty of candour (Scotland) Regulations 2018
22
GDPR came into force on:
May 2018
23
Privacy notices relating to GDPR must include the following:
Who it will be shared with. Retention periods for the data. Explain lawful purpose for which you are processing personal data.
24
When applying GDPR, consent of the data subject must be
Separate from other terms and conditions Specific Given freely Informed
25
Which of the following are true in relation to GDPR in dental practices
A subject access request by the patient to see their records may be made verbally Practices should have an all-staff data protection and information governance training programme Dental practices carrying out NHS care must appoint a data protection officer
25
Following treatment the person responsible for the recording of treatment undertaken on that visit is:
The Dentist who performed the procedure.
26
Under which of the following circumstances may information be legally divulged?
A patient has transferred to another practice and wishes to have a copy of all of her treatment records to take with her. A dental insurance company request with written consent
27
You are producing a new person specification for a dental nurse post in your practice. Which of the following criteria contravene Equal Opportunities legislation?
Under 40 years of age 5 years experience Wheel chair user Female
27
By law, Civil Partnership is a protected characteristic, but marriage is not.
False
28
You plan to change the pay rates in your dental practice. During the process you fail to inform employees about development opportunities and sources of support. This is:
Acceptable
29
You need to recruit a replacement dental nurse. The previous employee had multiple absences leading to a disruption in the service the practice provides and so you wish to avoid a recurrence. As a preventative measure and to improve the service the practice provides you ask questions about the applicants’ health and absences from work. This is:
Illegal under the Equality Act 2010.
30
The hygienist at the practice is able to carry out normal day to day activities, but suffers from a mental impairment. This is defined as a disability under the Equality Act 2010.
False
31
One of the nurses at he practice has visual impairment, and feels unsafe walking home alone in the dark. Which of the following would be a reasonable adjustment on the part of the practice owner?
Agreeing a flexible working pattern for the nurse affected.
32
When recording consent, which of the following statements should always apply?
The records should include medical history, any radiographs taken Notes on patient discussions should be made Accurate and legible records be kept
33
A fourteen year old boy attends your surgery with severe toothache. How should you proceed?:
Examine him, fully explain the treatment and proceed if you are happy he understands
34
For which of the following procedures would the GDC Standards for the Dental Team specify that written consent must be obtained?
Extraction of impacted LL8 extraction under GA General anaesthetic Extraction of LLE under GA
35
For which of the following proposed dental treatments is written consent necessary according to GDC regulations?
Fillings and extractions under general anaesthesia Fillings under inhalation sedation Extractions under inhalation sedation
36
An unregistered patient with toothache makes an appointment and subsequently comes into the surgery and sits down in the dental chair when called. What treatment can you carry out without obtaining further consent?:
Examination of the teeth and oral soft tissues
37
Under the public services reform (the Scottish public services ombudsman) healthcare and whistleblowing order 2020, who can raise a concern about NHS services
NHS volunteers Trainees and students Former NHS employees Current NHS employees
38
The Independent whistleblowing officer
Is an NHS authority that facilitates investigation of concerns in Scotland Cannot investigate anonymous complaints Routinely accepts complaints by email and telephone Can investigate health and safety concerns?
38
If a patient has a welfare proxy with the authority to consent, which of the following statements is/are true?
If the proxy refuses, treatment can go ahead if authorized by a practitioner appointed by the Mental Welfare Commission
39
A child does not want orthodontic treatment. His parents or legal guardians want their child to have straight teeth and a perfect smile and insist he is treated. You have...?
No consent to provide orthodontic treatment for him
40
A Section 47 Certificate (select any/all correct answers)
Can be completed on a “Word” document if it follows exactly the wording of the prescribed form
41
Where the adult has no proxy, which of the following is authorised to provide treatment, subject to certain safeguards and exceptions:
A certificate of incapacity issued by the doctor primarily responsible for the patients care
42
For the purposes of the Adults with Incapacity (Scotland) Act 2000 the term “incapable” describes an adult:
Unable to communicate decisions Incapable of retaining a memory of their decisions Incapable of understanding the consequences of their decisions
43
For an adult with incapacity, what must a dentist consider before administering treatment
The individual’s past wishes The benefit to the individual The procedure that is the least invasive The procedure that restricts the individual’s freedom as little as possible The wishes of the nearest relative
44
Our statutory duty of Candour was provided for in the Health (Tobacco, Nicotine etc. and Care) (Scotland) Bill, passed in March 2016. Which of the following Inquiries and Reports resulted in this legislation?
The Francis Report 2013
44
The main recommendations from the 2013 Francis report of the Mid Staffordshire Trust enquiry included which of the following?
A fundamental shift to a person centred culture Greater cohesion and staff engagement Openness, transparency and candour should exist throughout the system
44
GDPR applies to
Controllers and Processors
45
GDPR gives data subjects which of the following
The right to be informed about the collection and the use of their personal data The right to erasure or restrict processing in certain circumstances The right to object processing in certain circumstances The right to withdraw consent at any time (where relevant) The right to access personal data and supplementary information The right to have inaccurate personal data rectified, or completes if it is incomplete
46
Which of the following elements of a record are covered by the Data Protection Act, if it is all that is held on a practice computer based management system?
Telephone Log Clinical photos Credit rating GDP’s clinical notes Payment history Medical history Family members and relationships Patient’s telephone number and address
47
The partner of a patient phones asking you to confirm the time of their appointment the following day. Do you...?
Tell them you cannot give this information without permission from the patient
47
Which of the following statements is true? The dental records of a deceased adult person:
Can be assessed by a third party under The Access to Health Records Act 1990 Can be disposed of 11 years after patient’s death
48
Clinical records must be (select all that apply):
Secure, Dated, Contemporaneous, Legible, Comprehensive
49
Who has primary liability for a VDP’s patient’s dental notes being written up correctly?
VDP
50
The new dentist of a former patient of yours with the patient's permission requests the patient's records. What records must you release to their new dentist?
Copies of all records and radiographs
51
Do the police have access to clinical records?:
Yes, if a judge or sheriff so orders
52
Under the Equality Act, a person could suffer harassment on the grounds of?
Age, Sexual orientation
53
You want to change the pay rates in your newly acquired dental practice and so you arrange private meetings with each individual team employee to discuss their personal circumstances and due to the sensitivity of this matter insist on confidentiality.
Illegal under the Quality Act 2010
53
If you suspect a child patient may be suffering neglect, which of the following is/are an appropriate course(s) of action?
Contact your local child protection scheme Discussing the details with your defence organisation Discussing the details with a colleague
54
On a domiciliary visit to a new patient you notice that the patient has very poor personal hygiene and is living in squalid conditions. The patient lives with her son who claims to have Power of Attorney (POA) for both Welfare and Finance. The patient is capable of consenting to the treatment, however, she demonstrates a poor understanding of the costs involved. What should you do?
Contact Office of Public Guardian to confirm POA and contact Local Authority to report concerns
55
GDPR stands for
General Data Protection Regulations
55
Which of these is defined as a protected characteristic within employment legislation?
Age Sex Marriage and Civil Partnership
56
Which of the following are correct?
It is the responsibility of the practice to determine what reasonable adjustments are required to meet the needs of disabled patients.
57
Which of the following are required in order to have obtained informed consent?
Patient understands proposed treatment Patient understands why proposed treatment is needed Patient understands consequences of not undergoing treatment Patient understands potential risks of treatment Patient understands alternative treatments Patient understands risks of alternative treatments
58
An 9 year old girl presents at your surgery having sustained a large, sensitive enamel-dentine fracture to her upper permanent central incisor. She attends with her Aunt with whom she is staying on holiday, her parents are not contactable. What treatment should you carry out?
Treatment you consider to be in her best interests Ideally only treatment that is reversible
58
A child of 15, who is able to understand an explanation, attends your surgery requiring XLA of a carious tooth. The child refuses parental involvement in the decision-making process. Which of the following actions is appropriate?
XLA of tooth, document carefully all discussions Explain the possible consequences of the treatment proposed
59
Which of the following pieces of information might help a patient to make a decision when consenting to a course of complaint regard GA treatment?
The consequences, risks and benefits of the treatment proposed Whether treatment is guaranteed, and any exclusions that might apply Why you think a particular treatment is necessary and appropriate for the patient
60
For which of the following procedures is written consent essential?:
LR4 Extraction with LA under intravenous sedation Impacted LL8 extraction under GA General anaesthetic LL4 Extraction with LA under inhalation sedation
60
A patient’s Medical History can be shared with which of the following without consent?
The patient’s General Medical Practitioner Consultant colleagues on referral
60
You are half way through a root treatment and the patient wishes to stop due to it being very painful. You are aware that it would be beneficial for the patient to complete the treatment. Should you:
Acknowledge the patients request and follow their wishes Stop treatment, but explain the possible risks and consequences of not continuing treatment and highlight that the patient is responsible for future problems Document all discussions in the patients notes
61
For a patient’s consent to be valid, which of the following must apply?
The patient must be informed of the risks involved in a procedure You have to believe they are able to understand what is involved in a procedure
62
Consent of the data subject must be
Given freely Specific Separate from other terms and conditions Informed
63
When photographs are taken as part of patient’s examination and treatment, which of the following statements apply?
If the photograph is to be used for teaching or publication purposes, written consent should be obtained Patient consent must be obtained through an explanation of the purpose of photography
64
Your patient has recently appointed her husband and son as joint welfare attorneys. As her dentist, how should you decide whose views you must consider when the patient cannot consent to treatment by herself?
You should refer to the patient’s individual POA document for specific instructions
65
If a Dental Practitioner is unsure if a patient who is deemed incompetent under the Adult with Incapacity (Scotland) Act 2000 has a welfare proxy, he/she could establish the identity of any proxy by contacting a number of authorities. These include:
The patient’s doctor Social Services The Office of the Public Guardian (Scotland)
65
A section 47 certificate issued under the Adults with Incapacity (Scotland) Act 2000 should:
State that the person with incapacity is unable to make treatment decisions Valid for the course of treatment Detail any proposed treatment Only be signed by a dental practitioner if they have completed an approved training course
66
Which statement are true of treatment plans and Section 47 certificates:
The authority for carrying out treatment specified can be delegated to other members of the dental team within their competence Even if there is an ongoing treatment plan, it is best to have a separate certificate for a one-off procedure under general anaesthetic
67
The Adults with Incapacity (Scotland) Act 2000 can be applied to:
Patients with acquired brain injury Patients with severe sensory impairment Patients with Dementia
68
The definition of “incapacity” in the Adults with Incapacity Act includes (Please select all correct options):
Being incapable of remembering information for long enough to make a decision Being incapable of understanding the consequences of a decision
69
Mrs Roberts was recently diagnosed with dementia. She wanted her husband to be able to look after her affairs should she become more confused. Both Mrs Roberts and her husband Graham visited the family lawyer and organised for Graham to be in a position to look after his wife’s financial and welfare requirements if and when she becomes incapable. As Mrs Roberts’ dentist, which role is it important for you to know that Graham holds?
Continuing and Welfare Power of Attorney
70
Under the AWI Act, who is responsible for investigating circumstances where a person’s welfare may be at risk (where that person comes within part 5 of the Act)?
The Local Authority
70
A data protection officer must
Must have knowledge of the data protection law
71
In order to register for Data Protection you must pay an annual fee to...
The Data Protection Commissioner (also known as the Information Commissioner)
72
A breach of confidentiality could lead to?:
Prosecution by the Data Protection Commissioner under the 2018 Data Protection Act A complaint to the General Dental Council of professional misconduct Action for damage by the patient(s) or their personal representative(s)
73
Which of the following are appropriate methods for the disposal of patient records?
Private confidential disposal services Shredding
73
For medico-legal reasons, what is the min period, in years, that adult patient records should be kept in electronic form?
11
73
If there is a breach of data the DCP should inform the ICO no later than
72 hours
74
To comply with the Consumer Protection Act 1987 how long should you retain an adult patient’s dental records?
11 years
75
With respect to writing-up patients’ records which of the following statements are true?
The examining/treating clinician is liable for maintaining his/her own records
75
According to the Information Commissioner’s Office advice, ‘’the BDA have established he following recommendation for retention of dental records:’’
11 years or until the patient is 25 years of age, whichever is the longer
76
For the purposes of the Consumer Protection Act 1987, a child patient's records should be kept for?:
11 years or up to age of 25 (whichever is longer)
77
if asked by the Practitioner Services (Dental) to provide a patient record, how long does a dentist have to supply the record?
14 days
78
Under the protected characteristic of sex, a woman may not be treated less favourably if she
Has had a baby in the last 26 weeks Is breast feeding Is pregnant
78
What is considered special category data
Ethnic origin Race
79
The definition of a person’s race includes?
Nationality Colour Ethnic origin
80
You want to change the pay rates in your newly acquired dental practice and so you arrange an all employee meeting to discuss. At the meeting you inform all the employees to keep the discussion on pay rates confidential from employees of the competitor dental practice nearby. This is:
Acceptable
81
The dental nurse you have just interviewed and appointed then informs you that she is pregnant What should you do?Select all that apply.
Inform the unsuccessful candidates that you appreciated their attendance at the interview but that they were unfortunately unsuccessful. Offer the newly appointed nurse a written contract of employment within 3 months of their start date.
81
What course of action could legally be taken by the employer if a member of staff discriminates against a co- worker?
Verbal warnings Written warnings Dismissal

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