ethics and law Flashcards
what should you do with a patient with a blood bourne illness who doesnt want it disclosed
you do not have to disclose it
but you should say why it is in their best interests
why is it in a patients best interests to have blood bourne illness status disclosed
certain drugs will be handled differently by your body
drugs may be given which interact
it is possible to use a code in the letter so that only the doctors will know
every medical person has a duty of confidentiality
only those directly involved in your care will now
a patient wants to be treated for an STI but doesnt want it to be on the records
it must be put on the records
the GPs have a duty of confidentiality
they can go to a STI clinic confidentially
can you break confidentiality for STIs
only blood bourne
however you must try to persuade them
(they may have irreversible complications)
it is better to tell them now than them finding out later
you could both come in together
the clinic could send an anonymous letter
aims of the station
empathise be non judgemental address concerns address confidentiality try to offer solutions
what are the two steps to assessing capacity
does the patient have a disturbance or mental impairment?
does this mean they are unable to make a decision as a result?
- understand
- retain
- use
- communicate
who makes the decision if the patient lacks capacity
doctor, unless a someone has legal power of attorney
how do you decide a patients best interests
persaude the patient to be involved
take into account their beleifs and veiws
consult anyone named by patient to determine what might be best
check for lasting power of attorney
consider if they may regain capacity
how do you document
clearly document capacity assesment
if you are stopping the person from doing what they want you must fill out a deprivation of liberties safeguarding form
how do you consent for a procedure
explain what it is
explain reason for it
explain
procedure details
risks and benefits
alternatives
what is gilleck competence
a child under 16 can consent but not refuse treatment if they have sufficient maturity and judgement
parents cannot overide this
what are the fraser guidelines for contraception
can prescribe to under 16 year olds
what do you do if a patient continues driving after being told not to
eventually, you must break confidentiallity and inform DVLA
what is an advance directives
states what treatment a patient would not want
cannot state what they do want
what makes and advance directive legally binding
signed
witnessed
not under duress
sound state of mind when signed
relatives have no right to overrule
