Ethics and Law

Question 1

What are the GMC’s four main functions:

Answer 1

Question 2

Why ethics must be at the center of the medical practice?

Answer 2

Question 3

What are the 4 Principal Virtues?

Answer 3

Question 4

What is Utilitarianism? Where would this be used?

Answer 4

Question 5

What are the problems with Utilitarianism?

Answer 5

Question 6

What is consequentialism?

Answer 6

Question 7

What is Deontology?

Answer 7

Question 8

How would you approach this case using Information Gathering / interrogation / Practice?

Answer 8

Question 9

How to approach moral dillema scenarios by structured answer?

Answer 9

Question 10

What is the BMA’s definition of consent?

Answer 10

Question 11

What a valid consent made of? (3)

Answer 11

1. Information.
2. Voluntariness.
3. Competence.

Question 12

Consentual competency, involves the ability to: (4)

Answer 12

1. To understand relevant information.
2. To retain that information.
3. To use or weigh up that information to make a decision.
4. To communicate that decision.

Question 13

Consent should compraised of: (4)4.

Answer 13

The acronym is PARQ:

1. Procedure - What it is for, what it entails, what it will feel like (nature and purpose).
2. Alternative processes.
3. Risks (including risks of doing nothing).
4. Quesitons.

Question 14

What are the 3 models of “Adequate” information for consent, i.e the ways we can look at the amount of information needed to get consent as enough?

Answer 14

1. Profession practice standard - confroms to prefessional practice (what is considered professional standard).
2. Reasonable / Prudent person standard - hypothetical reasonable person (what a person would consider as something to worry about).
3. Subjective standard - enables individual to make informed choice.

Question 15

What the Sideway (& Bolam test) say in court regarding a physician’s negligence?

Answer 15

Question 16

What is the Montgomery Law?

Answer 16

The doctor is under a duty to take reasonable care to ensure that the patient is aware of any ‘material’ risks involved in proposed treatment, and of reasonable alternatives.

Question 17

Under the Human Tissue Act, consent is needed for the removal, storatge and use of material from the deceased for all scheduled purposes, including: (3)

Answer 17

1. Transplantation.
2. Education or training.
3. Public display.

Question 18

Consent “Voluntariness” includes 2 elements:

Answer 18

1. Patinet must be able to refuse.
2. Patient must be free from undue pressure - coercion and percieved coercion.

Question 19

What is the scope of consent ?

Answer 19

Consent is specific to treatment or procedure?

Question 20

If the doctor-in-charge would like that consent to be taken by a delegate (someone else, another doctor), what are the 3 things one should make sure regarding the delegate:

Answer 20

1. Is suitably trained and qualified.
2. Has sufficient knowledge of the procedure, including risks and benefits.
3. Understands, and agrees to act in accordance with, the guidance in this booklet (GMC’s guidlines).

Question 21

When consent is NOT necessary?

Answer 21

Question 22

An incompetent / unconscious patient, is a one which: (3)

Answer 22

Question 23

What are the main problems with inofrmed consent (practical problems)?

Answer 23

Question 24

What’s the heirarchy of evidence?

Answer 24

Question 25

What are the 2 types of categories of Effectiveness?

Answer 25

Question 26

Give specific issues relating to assessemtn of clinical Evidence Quality (TOPICS CS)

Answer 26

Question 27

What are the 5 Ethical Significance points of confidentiality?

Answer 27

• Autonomy
• Rights to privacy
• Welfare/beneficence
• Trust – trust depends upon it
• General utility concerns

Question 28

When it is you can breach confidentiality against child’s?

Answer 28

1. Overriding public interest
2. Best interest of incompetent child
3. Disclosure required by law
   
   • Must disclose if required by law (e.g. known or suspected communicable disease). Tell patient if practicable, but no consent required.
   • Must disclose if ordered by a judge (but can object if you feel information wanted is not relevant

Question 29

• What does public interest mean (in the context of breaching information)?

Answer 29

1. Only the ‘most compelling circumstances’ justify a doctor breaching confidentiality
2. There must be a real and serious risk (not simply a ‘fanciful’ possibility) of physical harm to an identifiable individual or individuals
3. Disclosure must be made only to those who are in vital need of the information

Question 30

What is the stand of Statutory Provisions on Disclosure of Information and breaching of privacy? What are the cases where it should be disclosed?

Answer 30

1. Notification of births (including stillbirths) and deaths
2. Fertility treatment
3. Communicable diseases
4. Termination of Pregnancy
5. Addiction to drugs
6. Poisonings and serious work accidents
7. Terrorism
8. Court orders under the PCA 1984
9. The epileptic driver (or impaired driver)
10. The patient who is HIV positive and other sexual health cases
11. The abused patient (children and adults)
12. The sexually active minor

Question 32

According to the GMC, does confidentiality dies with the patient? What about according to the law?

Answer 32

• Confidentiality and Death
  
  • The GMC state doctors must follow the ethical position and respect confidentiality after death
  • Legally: duty seems to die with the patient