Ethical and Legal issues Flashcards
Is an ADRT legally binding
Yes
Is an advanced statement legally binding
No
What is an LPA
Individual appointed to make decisions on pt behalf if capacity is lost
What are the 6 principles of safeguarding investigations
Empowerment Protection Prevention Proportionality Partnership Accountability
Safeguarding Ix - empowerment
Decisions are led by patient and investigations are carried out w/ informed consent
Safeguarding Ix - protection
Those in immediate/continued danger are protected from harm
Safeguarding Ix - proportionality
Proportional intervention will be made that = the least intrustive appropriate to risk presented
Safeguarding Ix - partnership
Solutions delivered by services, which detect + report neglect + abuse
Health + social care
OSCE station on safeguarding - what must be covered
Communication skills: clarification, checking and summarising
Establish facts RE abuse
Psychological factors incl drugs and alcohol
RF for abuse
Exploration of carer stress
Correct Mx - Rx, social services support, pt needs to stay in hospital, consultant will need to review
Escalation of concerns to safeguarding NUH
1 - Ensure pt immediate safety
2 - Inform nurse manager
3 - Request exam by reg + completion of body map
4 - does pt have caring responsibilities, is another vulnerbale person involved?
5 - Inform NUH safeguarding team
6 - Phone adults safeguarding referral to social services within 24hrs
7 - Inform family Rx has been make
8 - Carefully document discussion in med notes
9 - Complete incident form
10 - do not discharge until MDT agree approp safety plan
What are the 4 ethical principles
Non-malificence
Beneficence
Automony
Justice
Non-malificence
Harm to pt should be avoided or minimised
Beneficence
Health professionals should always try to act to pt’s benefit
Autonomy
pt has right to self determination, which should be respected at all times
Justice
Healthcare professionals should always act fairly
WHat 3 things is justice subdivided into
Legislative (specified in statute or by legal precedent)
Rights based - based on agreed principles of inalienable human rights
Distributive - based on fair and equitable distribution of available resources across society
‘Benefits’ of diagnosis of dementia (5)
Ascertain Tx preferences Make will/LPA/Advanced directive Plan for disability Right to know their diagnosis Better support and access to help psychological adjustment
Suggested guidelines for disclosing diagnosis (9)
Use MDT approach to answer Q Consider telling pt and carer together Allow time to talk + answer q Arrange follow up meetings for discussions Discuss disease progression Agree care plan Prov educational materials Prov list of community resources/contacts Arrange further support
What is testamentary capacity
Ability to make a will
Driving + dementia
Legally obliged to tell DVLA once diagnosed
DVLA will investigate using GP, psych reports + driving assessment
2 outcomes of driving + dementia
New license valid for 1 y
License revoked
MHA 1983
Protects rights of pt w/ mental disorder without consent if necessary. COvers only Tx for mental disorder.
= to control
MCA 2005
Empowers + protects people 16+ who lack capacity.
To make decisions
To assist, support + enable
Covers Tx for physical and mental conditions
What is the 2 stage test of assessing capacity
1 - Is there impairment/disturbance in the functioning of persons mind/brain
2 - Is the impairment/disturbance sufficient for person to lack capacity to make the decision (understand/retain/weigh up/communicate)
