Consent, Capacity, Confidentiality and Children Flashcards

You may prefer our related Brainscape-certified flashcards:
1
Q

R v Dr Flattery

A
  • Dr said breaking a womans hymen would stop her fits
  • She didn’t understand what this meant but consented
  • Resulted in him being convicted of rape.
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2
Q

Function of the GMC

A

Maintain a list of doctors

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3
Q

Function of the BMA

A

Trade union

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4
Q

Function of the MPO

A

Medical protection organisations (MDU, MPS)

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5
Q

Function of the NHS

A

Provider of health services

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6
Q

Function of the CQC

A

Ensure quality (care quality commission)

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7
Q

Function of the NICE

A

Ensure value (national institute for clinical excellence)

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8
Q

Compare common law and statue law

A

Common law

  • Based on tradition (custom before 1066)
  • Heavy weight on judicial interpretation (cases - looks at decisions made in similar cases)

Statute law

  • Laws passed in parliaments
  • Effectively include executive powers by government agencies
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9
Q

Compare criminal and civil law

A
  • Criminal law is offences that negatively affect society as a whole, rather than just one person.
  • Civil law is behaviour that causes injury to a person or group of people (eg. negligence)
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10
Q

Describe the process of civil law

A
  • Remedy is compensation (people want money)
  • Claim for damages
  • Two parties with a relationship but no contract (tort law - civil wrong)
  • Aggrieved party = claimant
  • Defending party = defendent
  • Less than 1% go to trial
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11
Q

Describe the process of criminal law

A
  • State punishes wrongdoer
  • Police investigate
  • Crown prosecution services
  • Judge and Jury
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12
Q

Which specialities are more commonly claimed against?

A
  • Obs and gynae highest cost value

- Surgery the most frequently claimed for

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13
Q

Describe the court hierarchy

A
  • Coroners court (unnatural deaths)
  • Crown court progresses to court of appeal then to high court (criminal)
  • County or high court (civil)
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14
Q

List exceptions to consent

A
  • Emergency
  • Implied (eg. sticking arm out for blood pressure cuff)
  • Waiver (do what you want, I’m not fussed)
  • Best interests
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15
Q

List presumptions for consent in adults

A

(Age 16 over)

  • Are assumed to have mental capacity to make treatment decisions
  • Unless there is contrary evidence
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16
Q

List presumptions for consent in children

A

(less than 16_

  • Assumed to not have mental capacity
  • Unless there is contrary evidence
17
Q

List components of valid consent

A

A competent person who understands the nature of the treatment based on information about risk without being coerced

18
Q

List the 4 things that must happen for competence to be met (in MCA test)

A
  • Understand the information
  • Retain the information
  • Use the information
  • Communicate the information
19
Q

List 5 key principles of mental capacity act 2005

A
  • A presumption of capacity in every adult
  • Right for individuals to be supported to make their own decisions
  • Right to make eccentric or unwise decisions
  • Best interests (everything done for or on behalf of people with no capacity must be in their best interests)
  • Intervention must be least restrictive of their basic rights and freedoms
20
Q

What is the medical capacity assessment test for capacity?

A
  • A single clear test for assessing whether a person lacks capacity to take a particular decision at a particular time
  • Decision specific test
  • No one can be labelled incapable due to a particular diagnosis
21
Q

Describe the case of bolam

A
  • Hospital failed to give Bolam muscle relaxant, didnt warn them the risks of the procedure, he was not strapped down and he fitted
  • Doctor was not held responsible in negligence as he was held to be acceptable to a reasonable body of other doctors
22
Q

Describe the case of Sidaway

A
  • Surgery for neck and shoulder pain
  • 1-2% risk of nerve root damage, lower risk of paralysis
  • Not told of paralysis risk and she ended up being paralysed
  • Surgery was performed competently
  • Tried to sue the surgeon but was unsuccessful as other doctors said he did procedure correctly (bolam)
23
Q

Describe the case of bolitho

A
  • 2 year old with respiratory infection
  • Drs didn’t come when asked to attend
  • Dr came later but child had cardiac arrest and had brain damage
  • If intubated would have not happened
  • Dr would not have intubated if he came earlier, so was not wrong
24
Q

Describe the montgomery case

A
  • Montgomery diabetic
  • During delivery complications
  • Shoulder dysplasia occured, hypoxic insult and cerebral palsy occured
  • Obstetritian didn’t say there was increased risk of this in diabetic women (10%), even after she asked
  • She sued for negligence and said she would have had a c section if she knew
  • Redefined standards for informed consent, rejected Bolam
25
Q

Define a material risk

A

In the circumstances of the particular case, a reasonable person in the patients position would attach significance to that risk

26
Q

List different aspects of material risk

A
  • Doctor doesn’t have to disclose if not in the patients best interest
  • Also in necessity (eg. unconscious or urgent treatment)
  • Patient should make decision whether to undergo decisions
  • Assessment of material list cannot be reduced to percentages
27
Q

Describe the spence v hillindon case

A
  • Patient had bilateral pulmonary emboli after a hernia operation
  • He didnt seek treatment immediately due to not being advised of risk of DVT or PE or symptoms that might indicate these
  • The judge found failure to inform the patient was a breach of duty of care
  • Montgomery applied
28
Q

Describe the case of T

A
  • 24 wks pregnant, RTA
  • Mother Jehovas Witness patient was not
  • Mother convinced patient to not have a transfusion, signed a form refusing consent to have it
  • It wasnt explained she may need one to save her life
  • Put on a ventilator
  • Her father and boyfriend applied to the court so she could have the transfusion, and it was deemed lawful to give blood
  • This is because the mother influenced her decision and she didnt know how much she needed it