ethical and legal2

Question 1

4 principles of biomedical ethics

Answer 1

• respect for autonomy
• non maleficence
• beneficence
• justice

*Secure and maintain dental health
Benefit from tx
Examination, special investigation to establish dx
*

Question 2

idemnity reflects

Answer 2

sphere of practice

more expensive out in practice than in hospital- NHS

Question 3

advertising practice

caution

Answer 3

ensure complies with guidance GDC 2012 and 2013

needs to be honest, accurate and derrogatory of anyone else

Question 4

breach confidentiality
when

Answer 4

need pt consent
or in public interest/best interest of pt

Question 5

3 times can disclose/share information

Answer 5

For direct healthcare purposes
e.g. tx, clinical audit

For health related purposes
Research, complaints, GDC, PSD/BSO/BSA, Ombudsman

For other purposes
Requests from police, solicitors, media etc

Question 6

protection of pt information

guidance and law

Answer 6

uk-GDPR -2020
Access to health records act 1990
* duty of confidentiality applies and continues after death

Where disclosure is approp, only the min amount of relevant infor necessary should be disclosed

Need written consent or solicitor mandate

Question 7

consent and parental resposibilty

Answer 7

check each time

revise - BDJ 28 Jan 2022

Question 8

types of consent

6

Answer 8

Verbal - pt asked
Implied - pt turned up
Express - written directive
informed
Written - provides clearest proof
Valid - most approp
* Valid= informed + competent + voluntary

Question 9

consent has to be

Answer 9

Need capacity to be able to decide

Need for each tx you do

Record discussion in dental records

Pt needs to make up their own mind

Question 10

common pitfalls in consent

4

Answer 10

Comprehension - do they understand
Timing - neither too early/late
Pressure - time/drawings/lit
Delegation

Check at each appointment
Pt needs to understand

Question 11

who is competent to consent

5

Answer 11

Pt with capacity

Parent with parental respon

Power of attorney
* Different types
* Health is our concern

Legal guardian

Court for a child

Question 12

can a 15yo mum consent for full clearance of her 2yo under GA?

Answer 12

yes - if she understands

tx the pt in front of you

Question 13

what can cause variation in consent capacity

4

Answer 13

drugs
alcohol
dementia
montgomery

Question 14

what to ensure to inform pt of during consent procedure

Answer 14

material risks to them

Question 15

what are material risks

Answer 15

Any risk pt may attach significance to e.g.
Lower 8s
* time off work
* nerve damage

Professional musicians
* OAF - off work 6 weeks
* Ortho tx

Question 16

Duty of Candor

Answer 16

legal in Scotland and England - Health Act 2016

but have a duty as GDC registrant

Question 17

what is Duty of Candour

Answer 17

Sits within clinical governance 7 pillars model
‘francis report’ 2012
GDC standards 1, 5, 8

GDC guidance when something goes wrong
e.g. Endo instrument break, Wrong tooth XLA
* Apologise (temp)
* Work out what can do
* Explain in their terms

Question 18

laws/quasi laws that dentist have to follow

7

Answer 18

• Dentists act 1984
• GDC rules
• NHS regulations/contracts/MHPS
• Guidelines - NICE, SIGN, resus, SDCEP, FGDP (record keeping, radiograph)
• Regulatory precedent - Grant, Cohen, Ivy
• Civil standard precedent -
• CQC, RQIA, HIW, HIS, DoH

personal regulations but also work environment ones