ethics and professional obligation Flashcards
main pillars about ethicd and professional obligation
INFORMATION GOVERNANCE AND
PATIENT CONFIDENTIALITY
= Do not share patient demographic
/personal or clinical details with anyone
who does not need to know as part of their
medical care and ensure security of records
==============
PATIENT
DOCTOR
RELATIONSHIPS
==========
CONFLICTS OF
INTEREST
============
KEEPING
NOTES
=========
patient safeguarding
how can INFORMATION GOVERNANCE AND
PATIENT CONFIDENTIALITY be compromised ?
Printing and losing patient lists, notes or correspondence
• Talking in stairwells, lifts or Costas
• Speaking on the telephone in clinical areas. • Getting the patient wrong- What’s your name please not
are you Mrs jones ? • Wrong stickers on request, resuscitation, discharge
letters and drug charts • Sharing passwords
• Social media
• Sharing information with families without patient consent
some doctorines of PATIENT
DOCTOR
REL ATIONSHIPS?
Maintaining professional standards at work and outside work
• Declare and openly determine how to manage/not
manage people you know
• You should not treat your family
• Do not start relationship with patients at work or after
discharge
• You should treat everyone equally with a fair allocation
of your personal resource irrespective of race, religion,
gender, sexuality, age, social class or ideology
what are some of the doctorines of keeping notes?
DATED, SIGNED LEGIBLE CONTEXED AND ACCURATE RECORDED AT THE TIME/
NEVER AMENDED ……….. UNLESS CLEARLY NOTATED THAT AN AMENDMENT HAS BEEN MADE
IF A PATIENT HAS COME TO HARM/ERROR OCCURRED NEVER CHANGE OR REMOVE NOTES
what is patient safeguarding ?
A process to raise, document and assess a concern around a patient’s care or treatment • Safeguarding means protecting a citizen’s health, wellbeing and human rights; enabling them to
live free from harm, abuse and neglect.
who are vulnerable adults ?
Those patients identified as higher risk for deterioration of health or adverse influence due to
mental, physical, educational, or emotional issues or with due to communication difficulties
• Legal definition: “adults over 18 whose ability to protect them self from violence, abuse or
neglect is significantly impaired through physical or mental disability or illness, through old age or otherwise”
• Example : learning difficulties patients have long LOS, poor health outcomes and higher
mortality than rest of population.
what approach is necessary with vulnerable patients?
Escalation and senior decision making- multiagency approach and advocacy
what is mental capacity ?
the ability to use and understand information to make a decision, and
communicate any decision made.
• A person lacks capacity if their mind is impaired or disturbed in some way, which means
they’re unable to make a decision at that time. •
Capacity may change with time and should be
assessed when a decision is required
Patients may lack capacity due to in toxification, dementia, delirium, psychosis, brain injury or
learning disability
• Capacity is decision specific- e.g. a patient may lack capacity to decide on treatment but have
capacity to chose between coffee and tea
what is the role as a doctor when a patient is lacking in capacity?
• if Urgent of decision making is n eeded – act in best interests of patients
• Principles:
Patient autonomy
Benefits of treatment Consequences of treatment
Fair use of health resources
Least restrictive option
Specific paperwork to record capacity Power of attorney- financial and health and welfare
what is deprivation of liberty ? (DOLS)
• Legal process to deprive patient of their liberty (often prevent from leaving hospital or treat
someone) when they lack capacity to make decisions around their safety and treatment
- Complex paperwork
- Legal requirement, must be in place and registered
- Time ltd and need renewal
what is consent ?
a person must give permission before they receive
any type of medical treatment, test or examination.
how can consent be valid ?
must give permission before they receive
any type of medical treatment, test or examination.
• informed – the person must be given all of the information about what the
treatment involves, including the benefits and risks, whether there are reasonable
alternative treatments, and what will happen if treatment does not go ahead
• Patient must have capacity
when are verbal consents to written consents indicated ?
Verbal- taking blood, having an Xray receiving medication
• Written- surgical and invasive procedures
• Consent for surgery should not SOLELY be taken by
junior medical staff- usually senior staff but juniors might document consent if assured the process has had
senior input to ensure patient is fully informed and they
are assured consent is voluntary and the patient has capacity
how to maintain the trust governance ?
Protocols and guidelines
• Processes and policies
• Adverse incident reporting
• Summary concerns risk assessment and risk of reoccurrence
• SIRI SEC and coroners post mortems
• Complaints - verbal and written
• Asap, communication, corporate apology, listening, honesty and transparency
DUTY OF CANDOUR- IF ERROR OCCURS HEALTHCARE PRACTITIONERS MUST?
1)tell the patient (or, where appropriate, the patient’s advocate, carer or family) when something has gone wrong
2)Apologize
apologies to the patient (or, where appropriate, the patient’s advocate, carer or family)
3) Offer
offer an appropriate remedy or support to put matters Offer right (if possible)
4)explain
explain fully to the patient (or, where appropriate, the patient’s advocate, carer or family) the short and long term effects of what has happened. E
