Block 4 Week 4: Scope & Limits of personal, professional & legal responsibilities of Dr's & medial students Flashcards
What are the Ethical arguments for Drs assisting in an emergency situation?
Consequentialist
•Greater ability to help- more skills/ knowledge/ expertise
Deontology (duty based)
•Professional duty of care
Virtue Ethics
•Virtues of a Dr -> kindness/ compassion
What is the Legal position on Dr’s helping in an emergency situation?
No legal obligation to assist
When does a legal position for Drs to assist in an emergency arise?
(Think more about in hospital)
•Legal obligation to assist: MUST be in an established professional duty of care
e.g. in hospital setting
- GP contractually obliged:
- During core hours
- Emergency within practice area
You are out an about: A person requires medical help?
a) Is there a legal obligation to help?
b) You decide to help- what has been establised?
c) Someone decides to make a negligence claim- what applies?
a) No legal obligation
b) If Dr identifies themselves & offers assistance in that capacity –> LEGAL DUTY of CARE established
Act only in clinical competence!
c) Negligence claims: Normal standard of care test applies
Social Action, Responsibility & Heroism Act (2015)
When is it used?
What does it consider?
Applied by the courts to determine the steps that a person was required to take to meet a standard of care
Applied when emergency care was required.
Considers:
- Was person acting for benefit of society?
- Demonstrate a ‘predominantly responsible approach’?
- Person acting heroically?
What is the professional obligation to help in an emergency
Must offer help in emergencies in clinical settings or community
Take into account: Own safety, Competence & Availabilty of other options for care
NHS Litigation Authority- what does it do?
What is not covered?
What does not apply?
NHS litigation authority provides indemnity (protection) for clinical negligence claims only for those listed in Dr’s contract
Good samaritan acts not necessarily included
Additional Indemnity for Good Samaritan Acts!
Not covered:
- Disciplinary issues by employer
- Referrals to GMC
- GP (contract/ locum/ salary)
Not Apply:
- Agency work
- Voluntary/ Charity
- Overseas
What is informal medicine?
Tx/ Consultation without record- keeping or follow up
What is professional guidance on looking after/ prescribing for friends/ family? (and yourself)
Whereever possible avoid prescribing medical care to yourself or anyone with who you have a close relationship
What are the arugments for tx family/ friends?
- Relationship of trust between Dr-Pt
- Greater understanding of person & context by the doctor
- Better standard care
- Reduced burden on NHS
What are the arguments against tx family/ friends?
- Emotional involvement- lack objectivity
- Asessment at home not as good as clinical setting (standard of care may be lower)
- Impaired relationship with their own GP
- Confidentiality
- Dr not want to explore sensitive topics (difficult as no detachment)
- Patient feel unable to refuse tx/ seek alternatives
Personal & Professional Boundaries:
You conduct should?
Social medial use
a) Justify your patient’s trust in you and the profession
b) Use sensibly- Privacy setting etc..
GMC guidance on: Personal & Professional Boundaries:
Relationships with current patients
Relationships with former patients
you must not use your professional position to pursue a sexual/ improper emotional relationship with patient/ someone close to them
Personal relationships with former patients may also be inappropriate depending on factors:
- Length since professional relationship ended
- Nature of previous professional relationship
- Was the patient vulnerable at time of professional relationship & if vulnerable now
- Will you be caring for other members of patient’s family
Medical Students- what should you consider?
- Aware of behaviour outside clinical environment (including personal lives) have impact on FtP!
- Behaviour must justify trust people have in medical profession
- Act in clinical competence!
What is the Guidance for medical students on medical electives when intervening in emergency situations?
- In resource poor settings situations can routinely occur that would be regarded as emergencies in more developed countries
- students must avoid getting involved in providing routine care that is outside theur level of competence
- if patient at immediate risk of death or serious harm, and no other HCP around, student can assist provided they have reasonable belief they can improve outcomes
