Block 11 - part 3 Flashcards
4 types of neglect
physical neglect
educational
emotional
medical
7 signs of neglect
malnutrition, poor hygeine, unattended physical/medical problems, frequent lateness/absence at school, inappropriate clothing, frequent illness, left unsupervised for long periods
4 types of child abuse
physical abuse
neglect
psychologcial abuse
sexual abuse
physical abuse
deliberate aggressive actions on child that inflict pain
neglect
failing to provide a child’s needs
psychological abuse
behaviours towards children that cause mental anguish or deficits
sexual abuse
touching a child in a sexual way or committing a sexual act with him or her
people involved in reproductive ethics debates
parents, future/existing child, third parties, including the state
parents involvement in reproductive ethics debate
procreative autonomy, parents wishes regarding reproductive choices should be respected, state interference should be minimal
future/existing child involvement in reproductive ethics debate
parents wishes should not be respected if not in interests of the future child
third party involvement in reproductive ethics debate
use of resources, health care providers objections of consequences
Main outcome of the human fertilisation and embryology act (1990)
‘a woman shall not be provided with fertility treatment services unless account has been taken of the welfare of any child who may be born as a result of the treatment (including the need of that child for a father)’
criticisms of the ‘welfare criterior’ in 1990 human fertilisation and embryology act
fertile couples don’t need to meet this criterion, predicting welfare of future children is very difficult, research suggests not the case that father is always required for a child to flourish
Main outcome of the human fertilisation and embryology act (2008)
continues to talk about a duty to take account the welfare of the child in providing fertility treatment (hence welfare criterion remains) but replaces reference of ‘need for father’ wtih ‘need for supportive parents’, thus valuing the role of all parents
pro-life argument (4 points)
abortion ends the life of a foetus, human foetuses have the moral status of a person (?), it is wrong to end the lif of a person/a creature with the moral status of a person (depends on circumstances?), therefore abortion is morally wrong
procreative autonomy
to have control over one’s reproductive capabilities, freedom to choose whether or not to have children
Abortion act (1967, amended 1990) stated:
A person shall not be guilty of an offence under the law relating to abortion when a pregnancy is terminated by a registered medical practitioner if two registered medical practitioners are of the opinion formed in good faith.
Criteria for ‘formed in good faith’ abortion act 1967/1990
Pregnancy has not exceeded 24 weeks, temination is necessary to prevent injury to physical or mental health, continuing pregnancy would involve risk to the life of the pregnant women, risk is that the child was born it would suffer from physical or metnal abnormalities
arguments for assisted reproduction
procreative autonomy, helps get around fertility problems, more successful than other types of assisted reproductive technology, can help single women and same-sex couples have a child
arguments against assisted reproduction
involves destruction of embryos, higher risk of multiple pregnancy with associated risks of mortality and morbidity, is ‘unnatural’, encourages mentality which views people as things which can be bought/sold, IVF babies at higher risk of birth defects, psychological and physical health risk on parents, ART can be expensive.
pre-implantation genetic diagnosis
genetic profiling of embryos prior to implantation, and sometimes even oocytes prior to fertilisation. Can be used to avoid genetic diseases
ethical issues with pre-implantation genetic diagnosis
sex selection, saviour siblings
3 views on conscientious objections of doctors to abortion
objections should always be respected, never, sometimes
argument that doctors objections should always be respected
autonomy of the medical provider is paramount, no-one should be made to do something that goes against their strongly held personal beliefs
argument that doctors objections should never be respected
women’s interests should always take priority, sometimes argued that if doctors don’t like it then they shouldn’t have chosen medicine as a career
argument that doctors objections should sometimes be respected
it might be possible for women’s interests to be met while at the same time not requiring doctors to do something that would cause then a great deal of stress
GMC position on doctors objections to abortion
objections can sometimes be respected - dr can refer pts to abortion services or provide with info
which act says that a 16 year old had full capacity and when was it published
the family law reform act 1969
gillick competency
child (under 16) can consent to medical treatment if deemed competent by medical professional, without need for parental permission or knowledge
fraser guidelines
doctors can give contraceptive advice and treatment to a person under 16 if she is mature and intelligent, likely to continue to have sex, and if the treatment is in her best interests
what should be done before performing an intimate examination
explain why exam is necessary and allow pt to ask questions, explain what exam will involve, get consent and record that pt has given it, offer a chaperone, give pt privacy to undress
role of midwife in postnatal care
identifying ‘at risk’ clients, support to make lifestyle changes (postnatal “window of opportunity”), signposting/liason/referral, health promotion, source of info, reassurance and support, safeguarding
8 aims from NICE postnatal care up to 9 weeks after birth guidelines (2006, updated 2015)
postnatal care plan for every woman, communication - particularly about transfer of care, information giving, assess health and wellbeing of mother and baby, alert women to signs and symptoms of potentially life-threatening conditions, encourage breastfeeding, assess emotional wellbeing, give info about baby’s general condition
7 people in pregnancy MDT
midwives, GPs, obstetrics, support workers, health visitors, maternity care assistants, public health practitioners
role of MDT postnatal care and support teams
continuation of the care the woman received during her pregnancy, labour and birth, and involve planning and regularly reviewing the content and timing of care, for individual women and their babies
11 barriers to MDT work
separate documentation, poor working relationship, lack of awareness and appreciation of the roles and responsibilities of others, limited time and resources, overlapping of roles, poor communication, lack of info sharing, lack of collaboration, lack of trust and confidence in abilities of other agencies, increased workload, lack of appropriately trained staff
