Ethics and Law Flashcards
What is an advance directive?
A document written at a time when a person is of sound ind, of that individual’s preferences with respect to medical treatment, should they later lose capacity
Must refer to a specific circumstance rather than a general statement
Who takes precedence, a advance directive or the decision made by an LPA?
The perspective of a lasting power of attorney has precedence over the written advance decision
How often should an advance directive be reviewed?
At regular intervals, eg every 2 years
Eligibility for carer’s allowance
Means tested:
Aged 16+
35+ hours/week caring for someone
Have been in England/ Scotland/ Wales for at least 2 of the last 3 years
Normally live in England, Scotland or wales, or you live abroad as a member of the armed forces
Not in full time education or studying for 21+ hours/week
You earn no more than £110/week after taxes
Which allowances are NOT means tested?
Carer’s credit, attendance allowance, personal independence payment (PIP) and disability living allowance
4 types of consent forms used in the NHS
Consent form 1: competent adults who are able to consent for themselves where consciousness may be impaired (eg. GA)
Consent form 2: for an adult consenting on behalf of a child where consciousness is impaired
Consent form 3: for an adult or child where consciousness is not impaired
Consent form 4: for adults who lack capacity to provide informed consent
What information must be present on a prescription for controlled drugs?
- Name and address of the patient
- The form and strength of the preparation
- Either the quantity (both wors and figures) of the preparation, or the number (both words and figures) of dosage units to be supplied
- Prescribers name, signature, address and current date
Cremation form rules
- 2 doctors are required to confirm both the identity and that the cause of death was not suspicious
- Cremation 4 form should be completed by patient’s own GP or a doctor looking after them during their last illness
- Cremation 5 form should be completed by an independent doctor with a full GMC registration for more than 5 years. They must discuss the case with the patient’s GP and view the body
- The two doctors must not be colleagues or relatives of the deceased, they must be independent of one another
- A fee is payable to each doctor
Death certification: notifiable deaths which must be reported to the coroner
- Unexpected or sudden death
- When the doctor attending the deceased did not see them within 14 days before death
- If a death occurs within 24hr of hospital admission
- Accidents and injuries
- Suicide
- Industrial injury or disease
- Deaths occurring as a result of ill treatment, starvation or neglect
- the death occurred during an operation or before recovery from the effect of an anaesthetic
- poisoning and illicit drugs
- still births
- prisoners or people in police custody
- service disability pensioners
DVLA rules for psychiatric disorders (group 1 vehicles: cars and motorcycles)
- Severe anxiety/ depression with significant memory problems, significant concentration problems, agitation, behavioural disturbance or suicidal thoughts:
- Acute illnesses, hypomania, mania, schizophrenia
- mild cognitive impairment
- dementia
- personality disorder
- Severe anxiety/ depression with significant memory problems, significant concentration problems, agitation, behavioural disturbance or suicidal thoughts: must not drive and must notify DVLA
- Must not drive during acute illness and must inform DVLA in the following: acute psychiatric disorder, hypomania, mania, schizophrenia
- Mild cognitive impairment: may drive and need not inform DVLA
- Dementia: may be able to drive but must inform DVLA
- Personality disorders: may be able to drive but must inform DVLA
DVLA rules for visual disorders
- visual field defect
- monocular vision
- Visual field defect: stop driving unless patient can meet recommended national guidelines for visual field
- monocular vision: must notify DVLA, can drive if acuity and visual field is normal in remaining eye
5 key principles of the mental capacity act
A person must be assumed to have capacity unless it is established that they lack capacity
A person is not to be treated as unable to make a decision unless all steps to help them to do so have been taken without success
A person is not to be treated as unable to make a decision because they make an unwise decision
An decision made under the MCA on behalf of a person who lacks capacity should be in their best interest
The decision should be the least restrictive of the person’s rights and freedom of action
Assessing capacity
A person is considered to be lacking capacity if:
- They have an impairment or disturbance in the functioning of the mind or brain whether permanent or temporary, AND
- They are unable to -
- understand the information
- retain the information
- use/weigh the info as part of the process of making the decision
- communicate the decision made by talking/sign language/other means
What are lasting power of attorneys?
A person elected by the patient who acts on behalf of the patient should they lose capacity in the future
Property, financial affairs, health and welfare decisions
They only have the authority to make decisions about life-sustaining treatment if the LPA specifies that
Can only be used if it is registered with the Office of the Public Guardian
What are the 3 main frameworks used when a person lacking capacity refuses treatment?
- Common law - used to treat patients in emergency situations
- Mental capacity act - used in patients who lack capacity and require treatment for physical disorders
- Mental health act - used in patients who require treatment for mental disorders
