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Pathology > E - Death and Law > Flashcards

E - Death and Law Flashcards

1
Q

who needs to be notified when a patient dies in hospital

A

consultant in charge of their care

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2
Q

which 2 laws apply when a pt is alive vs dead

A

alive = consent / confidentiality
dead = human tissue act / coronial law

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3
Q

what form is completed before death certificate

A

medical examiner’s statement of death notification document

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4
Q

what happens after cause of death is agreed

A

consented autopsy or medical certificate of death given

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5
Q

what happens if the cause of death is unclear

A

1) discuss with coroner
then either
- medical certificate of death issued
- autopsy

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6
Q

if a case is referred to the coroner, what happens next

A

autopsy

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7
Q

how is death verified (5)

A

no response to verbal / painful stimuli
no palpable carotid
no heart sounds
no breath sounds
pupils fixed and dilated (not responsive to light)

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8
Q

how long do you have to listen to heart sounds / breath sounds before declaring dead

A

2 mins each

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9
Q

once death has been verified, what needs to be done (4)

A

document in notes - date and time
notify consultant
discuss cause of death for certificate
arrange for family to be told

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10
Q

who issues the death certificate

A

the doctor attending during the last illness of the pt

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11
Q

who absolutely can NOT issue the death certificate

A

anyone who did not attend the pt

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12
Q

what details are on the death certificate (8)

A

pt name
date of death
age at death
place of death
dr’s name and date
cause of death
interval between disease onset and death
whether the death was due to employment or not

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13
Q

what is 1a on death certificate

A

disease / condition directly causing death

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14
Q

what is 1b on death certificate

A

any diseases contributing to 1a

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15
Q

what is 1c on death certificate

A

any diseases contributing to 1b

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16
Q

what is 2 on a death certificate

A

other significant conditions contributing to the death but not related to disease directly causing death

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17
Q

what things count as ‘modes of death’ and which should therefore be avoided as a cause of death

A

asphyxiation
cachexia
cardiac arrest
coma
failures - heart / liver / renal etc
shock

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18
Q

2 types of autopsy

A

consented (hospital)
medicolegal

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19
Q

under which type of autopsy can a medical certificate of death not be issued

A

medicolegal

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20
Q

what % of autopsies are hospital vs medicolegal

A

10% hospital, 90% medicolegal

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21
Q

purpose of hospital autopsies (5)

A

to determine:
- extent of disease
- response to Tx
- occult disease
to support
- training / teaching
- research / audits

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22
Q

who is involved in a forensic medicolegal autopsy

A

coroner
forensic pathologist
police

23
Q

who is involved in a coroner medicolegal autopsy

A

coroner
general pathologist

24
Q

what is the purpose of a coroner

A

determine who / when / where / how a person died

25
Q

what does the coroner actually do

A

instructs Dr to
- carry out autopsy
- determine MCCD on balance of probability

26
Q

6 reasons to refer to coroner (not specific causes of death)

A

unknown cause of death
not seen by a Dr during latest illness or last 28 days
during or within 12 months of pregnancy
death in custody
death whilst detained under MHA
death due to certain conditions

27
Q

9 specific causes of death that get referred to coroner

A

suicide
accident / trauma
industrial disease
medical / surgical Tx
abortion
anaesthetic care
lack of medical care
murder
self neglect

28
Q

what 4 features of a death would make you refer to coroner

A

any Hx of violence
any element of suspicion
any allegation of medical negligence
any other unusual / disturbing features

29
Q

when did the coroner’s rules come into law

A

2013

30
Q

who is ultimately responsible for the death certificate

A

the dr who signs it as the verifier of death

31
Q

what feature does the patient need to have in order to consent to something

A

capacity

32
Q

what feature does the doctor need to have in order to consent a patient for something

A

competency to take conset

33
Q

what law helps determine capacity

A

mental capacity act

34
Q

what is the purpose of the human tissue authority

A

oversees organisations that use human tissues for research / tx / post mortems / teaching / public exhibits

35
Q

when did the human tissue act come into law

A

2004 (came into effect sep 2006)

36
Q

what does the human tissue act cover

A

consent
performance of autopsies
storage of material retained
collection / retention of material from humans

37
Q

what do you need consent for regarding dead bodies

A

examination
removal
storage
ANY type of use - teaching / research / audit etc

38
Q

which part of HTA allows post mortem

A

16 (2) b

39
Q

which part of the HTA allows removal of body parts for any other purpose than transplantation

A

16 (2) c

40
Q

which part of HTA allows storage of a body for a schedule purpose

A

16 (2) e

41
Q

what are the scheduled purposes that a body can be stored for under HTA 16 (2) e

A

clinical audit
education / training related to human health
performance assessment
public health monitoring
quality assurance

42
Q

what can surgical human specimens be used for

A

diagnosis
teaching
audit / research

43
Q

what can the 2 types of post mortem human specimens be used for

A

consented autopsy = teaching, disease extent, tx response etc
coroners autopsy = ONLY for investigation into death ie not for research / teaching

44
Q

3 people who can consent for removal / use / storage of tissue after death

A

the pt themselves before they die
nominated person - before death, when pt had capacity
an adult in a qualifying relationship w pt

45
Q

what relationships to pt qualify to consent for removal / use / storage of tissue after death

A

(in hierarchical order)
partner / spouse
parent / child
sibling
grandparent / grandchild
niece / nephew
step parent
half sibling
longstanding friend

46
Q

when did the organ donation act come into law

A

2019 (came into force may 2020)

47
Q

what does the organ donation law state RE when consent for organ donation will be deemed

A

deemed if:
- no expressed consent / refusal prior to death
- no nominated representative

48
Q

when does deemed consent for organ donation NOT apply

A

children under 18
adult who lacked capacity for a significant period prior to death
an adult not resident in england for year prior to death

49
Q

when can deemed consent for organ donation be rejected

A

if family provide reasonable reason to believe that pt would not have consented

50
Q

when can confidentiality be broken (2 broad reasons)

A

patient consents to it
you can justify why

51
Q

4 broad reasons why you can justify confidentiality being broken

A

best interest of patient
safeguarding of others
statutory requirement
public interest

52
Q

statutory requirements to break confidentiality

A

road traffic act 1988
prevention of terrorism act 1989
public health (control of disease) act 1984

53
Q

does confidentiality continue after death?

A

YES - mandated by GMC

Pathology (87 decks)

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