Ethics and Law

Question 1

What criteria must be met before death can be verified?

Answer 1

No response to verbal or painful stimulus
No palpable carotid pulse
No heart sounds (2 minutes)
No breath sounds (2 minutes)
Pupils fixed and dilated

Question 2

After medically verifying a death, what must you do?

Answer 2

Document in the notes (with date and time)
Notify the consultant
Discuss the cause of death for certificate
Arrange for family to be notified

Question 3

When should you refer a death to the coroner?

Answer 3

• Unknown cause of death
• Not seen by a Dr during last illness or last 14 days
• During or within 12 months of pregnancy
• Death in custody
• While detained under Mental Health Act
• Death due to suicide accident/trauma, industrial disease, medical/surgical treatment, abortion, anaesthetic care, lack of medical care, murder, self-neglect

Question 4

Who appoints a coroner?

Answer 4

The local council.

Question 5

What are the sections of the Human Tissue Act (2004) that you should know?

Answer 5

You need consent for examination, removal, storage and ANY type of use including:
16 (2) b – a post-mortem examination
16 (2) c – The removal from the body of a deceased person of relevant material of which the body consists or which it contains for a scheduled purpose other than transplantation
16 (2) e – The storage of the body of a deceased person or relevant material which has come from a human body for use for a scheduled purpose

Question 6

What is the Human Tissue Act hierarchy of consent?

Answer 6

Partner/Spouse
Parent/Child
Sibling
Grandparent/Grandchild
Niece/Nephew
Step-parent
Half-sibling
Friend of long standing

Question 7

What does article 2 the Human Rights Act (1998) state?

Answer 7

Everyone’s life shall be protected by law.

• The right is absolute with respect to intentional killing
• Not all avoidable death counts as intentional killing
• There is no absolute obligation to provide life-saving treatment
• Withdrawal of futile treatment will not breach article 2
• The right does not extend to the foetus

Question 8

What does article 3 the Human Rights Act (1998) state?

Answer 8

No one shall be subjected to torture or to inhuman or degrading treatment or punishment.

• This right is absolute
• Non-consensual treatment of an incompetent individual may contravene article 3 if it is not therapeutically necessary
• Excessive restraint may contravene article 3

Question 9

What does article 5 the Human Rights Act (1998) state?

Answer 9

Everyone has the right to liberty and security of person.

• This is not an absolute right
• Detention is lawful for mental illness or prevention of infectious disease if it is in accordance with the law
• Individuals must have access to an effective and speedy means of challenging detention – there is an appeal process under the mental health act, and there are deprivation of liberty safeguards

Question 10

What does article 8 the Human Rights Act (1998) state?

Answer 10

Everyone has the right to their private and family life.

• This right is not absolute
• Protects a patient’s right to confidentiality
• Protects the right to refuse medical treatment even if lifesaving
• Article 8 will not be contravened if a breach is in accordance with the law and is necessary in a democratic society in the interests of national security, public safety, the economic wellbeing of the country, the prevention of disorder or crime, the protection of health or morals, the protection of the rights and freedoms of others