Duty of Candour Flashcards
What ethical principle underpins the moral obligation to act truthfully?
Autonomy - requires openness at all stages of contact with patients
Ethical duty to be open and honest
What are some broad reasons to act appropriately/honestly?
Moral duties derived from moral theories Legal duties (often based on moral duties) Regulatory duties (CQC) Professional duties (GMC)
Why is it important to be honest?
Significant part of relationships built upon trust eg doctor-patient relationship
It’s an important component of respecting people and their autonomy
We expect people to be honest with us
More important than just not lying - need to be open always
When might it seem acceptable to us to not be honest?
To protect ourselves
To prevent upsetting someone
= conflict as a Dr
Why is it important to respect patient autonomy when sharing information (honestly) with patients?
Info about diagnosis/prognosis Info necessary for INFORMED CONSENT Info on progress Info when things go wrong = being honest with the patient to allow them to trust you
Outline therapeutic privilege
Being honest with patients is vital to their informed consent making and promoting their autonomy, trust etc
But, sometimes telling a patient something might cause them harm = there’s an ethical argument to withhold info in some situations for the patients benefit
What are problems with therapeutic privilege? (withholding info in the best interests of the patient)
Who is best placed to make the decision on what’s best for them? Dr? Patient? Relative?
Does undermining autonomy harm a patient?
What if something goes wrong directly related to the withheld information?
Outline GMC guidance on openness and honest
PROFESSIONAL duty of candour
Every healthcare professional must be open and honest with patients when something goes wrong that has caused, or has potential to cause harm
Must also be honest with employers/colleagues
Should be honest before patients care, throughout care, and when things go wrong
What do patients need to know when things go wrong?
Patient should be informed as soon as possible and share everything you know What went wrong Why it went wrong Possible consequences for the patient Explain all uncertainties
GMC states apologies are only meaningful if they are genuine, what 3 components should they have?
What happened
What can be done to help with harm caused
What will be done to prevent someone else being harmed
What’s the statutory (organisational) duty of candour?
Healthcare organisations have a duty to support staff when adverse things go wrong, and to be open/honest with patients
Is statutory duty of candour a legal requirement?
Yes - Health and Social Care Act 2014
Formal process is trigged by incident resulting in harm to patient
Level of harm and cause is reported
What are the 3 levels of harm in the statutory duty of candour?
No harm - incident used for learning, not disclosed
Low harm - disclosure required under professional duty
Significant harm - disclosure required under both professional and statutory duties of candour
Drs have a duty to raise concerns where they believe patient care may be being compromised:
What are 3 important considerations when raising concerns?
Duty to put patients interests first, over loyalties to colleagues
Legal protection against victimisation for individuals who reveal malpractice in the workplace
Able to justify raising a concern if you do so honestly on the basis of reasonable belief - don’t need to wait for proof
