ethics Flashcards
when is it appropriate to break patient/doctor confidentiality with fitness to drive concerns?
when serious harm or death could come to others or the public.
inform the patient of your decision and explain the reasons why
when deciding whether the public interest
in disclosing information outweighs the
patient’s and the public interest in keeping
the information confidential, what must you consider?
- potential harm/distress to patient from disclosure - poor future engagement
- potential harm to trust in doctors generally
- potential harm to others if info not disclosed
- potential benefits to an individual or soc from release of info
- the nature of info + views of patient
- whetehr harms can be avoided or benefits gained without breaching the patients provacy or whats the minimum intrusion
who is legally responsible for deciding if a person is medically unfit to drive?
DVLA
what does the DVLA need to know to assess fitness to drive
about conditions or treatment that may affect their safety as a driver
who is legally responsible for telling the DVLA of conditions or treatment that may affect their safety as a driver?
the driver/patient
the docs responsibility is to tell the patient of when their condition is notifiable
- patient clearly is not doing so thats when doc has to make decision on when to disclose without patients consent to DVLA
- if they have dementia you should just disclose as soon as conveniently possible
what to do if you are unsure about whether someone is fit to drive?
- look in the DVLA’s assessing fitness to drive document
- seek advice of experiences colleague
- contact DVLA’s medical adviser
if you decide to disclose to the DVLA against the patients wishes what do you need to do?
tell the patient in writing
make a note in the patients record
who is responsible for assessing the risk posed by a member of the public who is armed with gun/knife ?
police
if a person arrives in A&E with a gunshot/knife wound what should you do legally?
infrom the police - even if accidental with licensed gun
what is the only time the police should not be informed with gunshot/knife wound?
if accidental or self harm with knife
if in domestic abuse and no one else is at harm and disclosing may make worse for patient
consult experienced colleague if in doubt
what should be disclosed when telling the police about gunshot/knife wound?
NOT - personal info eg patients name/address
what should you do if a patient refuses to talk about a gunshot/knife wound to the police?
abide by the patients wishes - they have the final choice
also ensure they are in a fit state to talk anyway, police shouldnt be allowed near them if it will hamper their treatment or health or trust in doctors
patient with gunshot wound - if a crime has been committed police will want more info - what should you do?
- seek patients consent for disclosing personal info unless:
- may put you or others at serious harm
- would be likely to undermine the purpose of
the disclosure, by prejudicing the prevention,
detection or prosecution of a serious crime - you have already decided to disclose
information in the public interest
- any worry about this just ask consultant or caldicott guardian
when disclosing without consent what do you note in patients notes
- reasons why you did it
- steps taken to gain consent
- how you informed them of the disclosure - or your reasons for not doing so
when making visual/audio recordings of patients you need to make sure you..
- ensure no pressure for consent
- informed consent - including the need, purpose, who will see recording
- stop recording if patient wants you to
- anonymise or code recordings
- make appropriate secure arrangements for storing recordings
