Forensic ⚠️ Flashcards

Question

what is **assent**?

Answer 1

A child's agreement to medical interventions and research

Answer 2

- Children under 18 & adolescent below 21 can agree to treatment if they're intelligent, competent - Doctors should listen to opinions and wishes of children who aren’t able to give full consent and should try to obtain their assent - Children should receive information in easy way to give their assent or dissent - Assent must protect the dignity, privacy and confidentiality of the child and his or her family

Answer 3

- The doctor has the duty to act in the best interest of the child - If parents refuse to consent, national laws and legal mechanisms may be used - The courts can make a decision if treatment is thought to be in the best interests of the child

Answer 4

- In an emergency, where treatment is vital and waiting for parental consent would place the child at risk, treatment can proceed without consent

Answer 5

Consent should be free, voluntary, clear, intelligent, informed, direct and personal

Answer 6

There should be no undue influence, fraud, misrepresentation of facts, compulsion, coercion or other consequences

Answer 7

- The knowledge regarding the intervention should be in understandable language and format so that decision can be made by the patient - A doctor should present reasonable information considering best practices

Answer 8

- Should be in a proper form and suitably drafted for the circumstances - The more specific the consent, the less likely it will be construed against the doctor or hospital in court

Answer 9

- The written consent should be witnessed by another person, present at the signing - To prevent any allegation that the consent was obtained under pressure

Answer 10

**When there is no nearest relative a physician may provide necessary treatment if:** a) He believes that the proposed treatment is essential b) another treatment provider agrees in writing that the proposed treatment is essential

Answer 11

- The **victim** cannot be examined without consent - The court cannot force a person to be medically examined - **Accused** person can be examined by a doctor using reasonable force, if requested by a police officer, if examination may provide evidence - **Arrested** person may be examined by a doctor at his request to detect evidence in his favor

Answer 12

- Better made by or under supervision of a female medical practitioner - Such an examination by a male doctor must be carried out in the presence of a female nurse - In **rape** cases, the victim should not be examined without her written consent - In **medico-legal cases of pregnancy, delivery and abortion**, the woman should not be examined without her consent

Answer 13

consent of both husband & wife should be obtained

Answer 14

law provides the consent

Answer 15

informed written consent of pregnant woman is obtained and a copy of the consent is given to the woman

Answer 16

**1.** A **set of values, behaviors, and relationships** that **underpins the trust the public has in doctors.** **2.** A **set of values, attitudes, behaviors** that **sets client’s self-interest before ➔ self-interest of the professional.** **3.**It is a **habitual & judicious** use of .(CK SFERV).... - communication - knowledge - technical skills - clinical reasoning - emotions - values - reflection in daily practice for the benefit of the individual & community. **4.** Professionalism is also the **moral understanding** among medical practitioners that **gives reality** to what is commonly referred to as the **social convention** between **medicine and society**.

Answer 17

Professionalism

Answer 18

- the sense of responsibility increases and improves the patient care

Answer 19

❶ effective **communication skills** ❷ achieving **excellence in skills** plus **ethics**.

Answer 20

- Professional competence that **should be practiced spontaneously** regarding ❶ upgrading your **knowledge** ❷ improving your **skills** ❸ better **communication** ❹ showing your **commitments and sympathy** ❺ giving **good explanation to your judgment armed with values** in all aspects that at the end of the day ensure safe patient with full satisfaction for all parties looking after the patient.

Answer 21

Medical professionalism was defined by many organizations such as - the American college of physicians - the European federation of internal medicine - American College of surgeons - American Medical Association - Association of American Medical Colleges

Answer 22

- an impressive **catalogue of virtues** in an **era** when **physician autonomy and self- regulation** are increasingly **challenged** by **third-party payers, patients and their families, and external critics**.

Answer 23

Physicians are expected, among other things, to ❶ subordinate their own **Interests** to the interests of patient (and to assume risk when doing so) ❷ **Strive** for excellence, knowledge, and competence ❸ work for **Fair** allocation of health care resources ❹ treat patients, physician colleagues, and other health care professionals with **Respect** ❺ avoid conflicts of **Interest** ❻ demonstrate **Sensitivity** to other cultures.

Answer 24

Principles are built upon the establishment of ❶ clinical **competence** ❷ **communication** skills ❸ **ethical and legal** understanding.

Answer 25

To show professionalism you must be: ❶ **Competent** in your field ❷ Good **communication** skills ❸ **Ethical** oriented

Answer 26

- The American Board of Internal Medicine (ABIM), who is leader and has explicitly, addressed the definition of professionalism in the 1990s - Their widely adopted definition was broad and inclusive and is composed of: **❶ 3 commitments ❷ 6 elements**

Answer 27

❶ To **maintain the highest standards of excellence** in the practice of medicine ❷ To **sustain the interests & welfare** of patients ❸ To be **responsive** to the health **needs of society**.

Answer 28

- Alturism - Accountability - Excellence - Honors - Integrity - Respect for others ## Footnote Profession ---> Commitment to professional ethics ----> Make evidence based decisions ----> Life long learner

Answer 29

**Having** a defined **set of values & principles** that allow to **demonstrate others’ behaviors & attitudes** that enable them to **work effectively cross culturally**.

Answer 30

- **Awareness** that **cultural differences & similarities** exist, **without assigning values** (better/ worse, right/ wrong) to those cultural differences

Answer 31

- **Familiarization** with the selected **cultural characteristics, history, value, belief systems, & behaviors** of **members** of another **ethnic group**.

Answer 32

حاجز في التواصل يظهر بين مجموعة لا تستطيع ان نتحدث نفس اللغة

Answer 33

- Probity - Alturism - Honesty & Integrity - Respect - Responsibility & accountability - Standards - Expertise - Commitment to excellence - Care & compassion

Answer 34

The word “probity” is taken from the Latin for **good, honest and upright**.

Answer 35

A professional person should be all these things, as well as **Fair & law-abiding** and of general **good character**.

Answer 36

Probity is **central to the public trust**, so medical **workers should**, through their actions, **uphold this reputation**.

Answer 37

- Pursue to serve patients and their families with perfect clinical care, **with their needs first** - **Assists colleagues/ learners** to address **personal issues** and **enhance knowledge and skills** required in a clinical or educational setting - Actively **support** the **educational mission** - Recognizes that the time and energy specified to performing these functions **should not interfere with time for caring for self and family**.

Answer 38

- One must **uphold the highest standards of behavior** and **refrain from words and actions that would violate** one’s personal or professional codes. - In learning and study, demonstrating honesty and trustworthiness by **referencing sources for intellectual material**. - Openly **identifies personal conflicts that interfere with patient's care**. - **Make sure the patient** can easily **understand the provided information** and **respects patients' confidentiality**

Answer 39

Honesty & Integrity

Answer 40

- There are **expectations** that a professional will **work and behave** in a manner that is **appropriate** to the nature of their particular profession. - In medicine, these expectations are unique ❶ good standards of **personal appearance and dress** ❷ appropriate standards of **speech and personal conduct** - such attributes (1,2) will confirm to a patient an acceptable standard of respectability

Answer 41

- hold and acknowledge in high regard feelings, opinions, and values of the members of the larger medical community whether at school, or in clinical environments. This should apply to: ❶ individual patients and their families ❷ other health care professionals ❸ colleagues, co-workers ❹ others with whom they come in contact. - One must **respect** the **dignity and autonomy** of individual patients, **take their beliefs and values into consideration**, and **maintain** their **confidentiality** at all times.

Answer 42

**focuses on what one can do and should do**

Answer 43

it defines the **duty and moral obligation** and responsibilities to: ❖ to individual patients ❖ to health care professionals ❖ to society ❖ to the profession.

Answer 44

- is often used interchangeably with responsibility, yet the terms are different. - Accountability measures **one’s behavior against established rules or norms**.

Answer 45

- **Placing emphasis on accountability risks that too much attention may be focused on the rules**, with both agent and overseer losing sight of what is ultimately important. - By contrast, **responsibility implies duty and moral obligation**. - Hence, the **responsibility relationship is one of trust**.

Answer 46

❶ Maintain professional **competence** and be committed to evaluating and upgrading scientific knowledge ❷ Seeks clarity on roles and responsibilities and **managing conflicts of interest** from colleagues, teachers, staff and preceptors. ❸ Attends to **own personal health through nutrition and physical activity** and seeks help when physically or mentally ill ❹ **Commits to excellence** in health care, improving access to care, and optimizing the health of the community ❺ **Seeks and gives feedback** to colleagues, teachers, staff and preceptors. ❻ Be **honest** with patients ❼ Respect **patient confidentiality** ❽ **Avoid inappropriate relations** with patients ❾ Advance **scientific knowledge** ❿ Improve quality and access of **care** ⓫ Promote the **just distribution of resources**

Answer 47

A professional person is expected to have the ability and dedication to **achieve a set of standards in their duties that their peers find acceptable**

Answer 48

- A professional person is expected to **have a particular set of skills** in their **chosen field**, at a level that **can be considered expert**.

Answer 49

❶ Learning ❷ Knowledge ❸ training and practice of the relevant skills

Answer 50

by qualifications or accreditation of some kind.

Answer 51

by ongoing training throughout the course of a medical career.

Answer 52

Excellence is a conscientious effort to exceed ordinary expectations

Answer 53

- It implies first a **commitment to lifelong learning**. - Besides, to **continually upgrade yourself** with new knowledge that requires a commitment to continued learning: ❶ **new studies** are published that have a direct impact on patient care ❷ practice **guidelines are revised and updated** ❸ **new drugs emerge**, and the efficacy and safety of existing drugs are regularly challenged ❹ **advances in technology** change the way health care is delivered ❺ **new legislation and policies** have implications on the practice.

Answer 54

**To care and to be compassionate** are at the very **center** of the **fiducial relationship** with the patient.

Answer 55

means to **attend to the needs of others** and to **have personal concern** for the well-being of another

Answer 56

has been defined as **expressing attitudes and actions of concern** for patients to **support** their **well-being**, **alleviate** Excessive **discomfort**, and **meet obvious or anticipated needs**

Answer 57

is to **recognize** and **understand** the needs of others **but, more important, to act on this compassion and desire to help them.**

Answer 58

A professional person will ❶ **Take pride** in doing a job well and pay attention to **D**etail. ❷ Take personal **R**esponsibility **for their actions and the consequences**. ❸ Seek to **D**evelop and improve their **skills**. ❹ **Not** be **S**atisfied with a **substandard result** and will seek to put things right. ❺ Be prepared to **A**cknowledge mistakes, **learn from them** and take appropriate steps to **prevent recurrence**. ❻ Show **R**espect for those who consult them in a professional capacity.

Answer 59

❶ **Compassion** for those suffering pain and hardship ❷ A proper and responsible role in **society** ❸ A responsible attitude to the **environment** ❹ Good employment **practices** ❺ An awareness of **social issues** where the medical profession is in a position to play an important or central role ❻ **Humanity** in both professional and personal matters ❼ Adherence to the **law**

Answer 60

❶ **Seek and accept feedback** and constructive instruction from teachers, peers, residents and faculty in order to continually improve educational experience, knowledge, and clinical skills. ❷ **Commit** to the highest standards of **competence**. ❸ Be **mindful** of demeanor, language, and appearance in the classroom, in the presence of patients, & in all health care settings. ❹ **Admit** to and assume responsibility for mistakes in a mature and honest manner and develop productive strategies for correcting them. ❺ **Refrain** - from using illicit substances. - from using alcohol, non-prescription or prescription drugs in a manner that may compromise judgment or ability to contribute to safe and effective learning. ❻ Be **considerate and respectful** of others’ (teachers, peers, residents and faculty) time, rights, values, religious, ethnic and socioeconomic backgrounds, lifestyles, opinions, and choices ❼ **Meet the expectations** for participation and timeliness that are communicated to me by those who teach me. ❽ **Recognize limitations** and seek help when one’s expertise, knowledge, or level of experience is inadequate to handle a situation in the classroom, hospital, or research setting.

Answer 61

It means **duty** of doctor, pharmacist & other **medical personnel** to **keep secrets they know about patient away from divulge, except in certain conditions**.

Answer 62

**Medical journals:** Not allowed to publish names or photographs of patient. **Hospitals:** Must keep information & investigations concerning any patient away from non-responsible persons.

Answer 63

- He is obliged to maintain secrets that he comes to know concerning patient in course of a professional relationship except when: 1. He is required by **law** to divulge secrets or 2. Patient has **consented** for its disclosure. - It is mandatory that whatever a doctor sees or hears in life of his patient must be treated as totally confidential.

Answer 64

- Can **sue** doctor for damages or face disciplinary action, If disclosure is **voluntary & resulted in harm to patient and is not in the interest of public.** - Disclosure would be failure of trust and confidence.

Answer 65

These terms have been used together in much of teaching we have received; thus, many may think they are synonymous, but they are not

Answer 66

- Is that **right or expectation not to be interfered with**, or more generally, a **moral right to be left alone** - Concerned with **setting within which patient’s medical information is taken. (i.e., patient’s body)**

Answer 67

- The **Right** of an individual to **have personal, Identifiable medical information kept out of reach of others** - **Concerned with information collected from / about patient. (i.e. patient’s information)** which Includes: - Written. - Computerized. - visual or audio. - recorded - simply held in memory of health professionals, this information is subject to duty of confidentiality.

Answer 68

- **Physician should not answer any query by 3rd parties, even when enquired by close relatives**, either with regard to nature of illness or any subsequent effect of such illness on patient, without his/her consent. **It includes:** - The individual’s past, present, or future **physical or mental health or condition**. - Any **clinical information** about an individual’s diagnosis or treatment. - **Pictures, photographs, videos, audiotapes**, or other materials of the patient. - **Who the patient’s doctor is and what clinics patients attend and when**. - Anything else that may be used to **identify patients directly or indirectly** - The past, present, or future **payment for the provision of health care to individual.**

Answer 69

- Email & fax - Electronic records - Manual records - All records - General measures

Answer 70

- Whenever possible, **clinical details** should be separated from **demographic data**. - All data transmitted by email should be **encrypted**

Answer 71

**Always** - **L**ogout of any computer system or application when work is finished. - Clear **s**creen of a previous patient’s information before seeing another. **Do not:** - Leave a **t**erminal un-attended & logged in. - Share Smartcards or **p**asswords with others. **Change:** - passwords at regular intervals to prevent others using them.

Answer 72

- Hold in **s**ecure storage. - **T**racked if transferred, with note of their current location within filing system. - **R**eturn to the filing system as soon as possible after use. - Stored **c**losed when not in use so that contents are not seen by others. - Kept on site unless removal is essential.

Answer 73

- Never inappropriately access records. - Shut / lock doors, offices & filing cabinets. - Query status of visitors / strangers. - Advise senior personnel if anything suspicious or worrying is noted.

Answer 74

**Limit** - Accessibility to medical records. - Sharing of information with other staff, unless in cases of consultations & second opinion. **Do not** - Discuss patient’s medical information with unauthorized family members. - Disclose patient’s information without his/her consent, or in established exceptions (below). - Collect information not related to the provision of care. **Set policies** - that regulate access to medical information & address how any breach to confidentiality is managed.

Answer 75

- There are issues related to the duty of doctors **not to harm their patients and to strive to do good for them.** **---------** - Breaching people’s privacy and disclosing their medical information irresponsibly is considered to be **professional misconduct which might cause psychological, social, and sometimes physical harm to the patient.** **-----------** - This harm may **extend to their families and colleagues.**

Answer 76

- Considered to be **professional misconduct which might cause psychological, social, and sometimes physical harm to the patient.** - This harm may **extend to their families and colleagues.**

Answer 77

- You are required to keep your patient’s body and medical information private and confidential. **----------** - Sharing them with the press, or with friends **may make you legally liable for your actions.** **---------** - You may **face unnecessary legal troubles** if the patient and/or his or her **family decide to sue you or your hospital and claim damages.**

Answer 78

- May make you **legally liable** for your actions. - You may **face unnecessary legal troubles** if the patient and/or his or her family decide to **sue you or your hospital and claim damages.**

Answer 79

**if patient is major (>18 years):** - Physician should **not disclose any facts about illness without his consent to parents or relatives even though they may be paying doctor's fees.** **In case of minor or insane person:** - **guardians or parents should be informed** of nature of illness.

Answer 80

- A doctor should **not disclose illness of his patient without his consent**, Even when requested by a public or statutory body, **except in case of notifiable diseases**. - If patient is **minor or insane**, **consent of guardian should be taken**.

Answer 81

Facts relating to nature of illness of one **must not be disclosed to other**, **without consent** of concerned person.

Answer 82

**No information should be given without consent** of concerned person.

Answer 83

physician **should not disclose any facts about illness without consent of servant**, even though master is paying fees.

Answer 84

- **Has right not to permit doctor who has examined him, to disclose** nature of his illness to any person. - **If convicted: he has no such right** & physician can disclose findings to authorities.

Answer 85

Any **information** regarding a **dead person** may be **given only** after obtaining **consent from a relative.** ## Footnote .

Answer 86

- Conditions of **permissible disclosure of professional secrets.** - A **statment** made **by a doctor** to **concerned authority**, **due to his duty to protect the interests of the community or of the state.** - **Exchange of information** between **2 individuals** in a **confidential relationship** ---> An **exception to professional secrecy.**

Answer 87

it must be made to person who has a duty towards it.

Answer 88

plea of privilege fails.

Answer 89

- request of patient himself - For sake of patient - For sake of public - For sake of medical men - In cases of expert witness

Answer 90

- If patient **asks or permits for this disclosure.** - As a rule, **his relatives & parents are not allowed to know his own secrets even after death.**

Answer 91

If patient is **mentally diseased**, **his relatives should be notified** for proper care & treatment.

Answer 92

In cases of **infectious diseases e.g. typhoid & AIDS:** - To prevent propagation of disease everywhere. - Proper authorities should be notified. In cases of diseases that is **contraindicated to his job:** - Uncontrolled Hypertension in drivers. - Gonorrhea among bathers in the swimming pools.

Answer 93

If he is **accused by malpractice**, he is **allowed to divulge secrets** about diagnosis and treatment followed.

Answer 94

- When a **medicolegal expert is asked to give a certain report in a certain problem.** - Medical persons working for insurance company can refuse to give a report about one of his own patients.

Answer 95

A doctor can disclose & discuss medical facts of a case with other doctors & paramedical staff, such as nurses, radiologist & physiotherapist to provide better service to te patient.

Answer 96

Covers all **failures** in the **conduct of doctors**, which **influence** their **professional skills, ability and relationships**.

Answer 97

civil and criminal aspects

Answer 98

- damage can be compensated by paying money

Answer 99

- Is more serious than civil negligence.

Answer 100

- When a **patient** brings suit **(claim)** in a **civil court** for **compensation** from his doctor, if he has **suffered injury due to negligence**. - When **doctor** brings a **civil suit** for the realization of **his fees** from patient or his relatives, who **refuse to pay, alleging professional negligence**.

Answer 101

- Practically limited to cases in which the **patient has died**. Doctor shows ❶ **gross incompetency** ❷ **inattention** in the selection application of remedies ❸ **Undue interference by him or criminal indifference** to the patient's safety.

Answer 102

Yes, A physician may be liable to both civil and criminal negligence by a single act. **Example:** - If he performs an unauthorized operation on a patient (illegal abortion) - Amputate a wrong limb **He may be sued in civil court for damages and prosecuted in criminal court for assault.**

Answer 103

- Professional misconduct (behavior) - Incompetence (skills) - Medical negligence (care)

Answer 104

Where the personal, professional behaviour falls below that which is expected of a doctor.

Answer 105

- The medical council is responsible for his punishment. - Any conduct of the doctor who might reasonably be regarded as disgraceful or dishonourable as judged by professional men of good repute and competence.

Answer 106

Registration can be resorted within 2-5 years ## Footnote العقوبات: اللوم والانذار –غرامة مالية تدفع في صندوق النقابة - او الشطب او سحب الترخيص

Answer 107

- Related to certificates & absence from work - Related to pregnancy & labor - Related to personal ethics - Related to ethics towards his work and collegues

Answer 108

Sexual act with mentally ill, unconscious, or anaesthetized patient.

Answer 109

- Sell poisons to the public, or prescribe steroids/ psychotropic drugs/narcotics when there is no medical indication. - Supply or sell addiction forming drugs to a patient other than medical grounds.

Answer 110

❶ Association with unqualified persons. ❷ Adultery. ❸ Advertising. ❹ Addiction. ❺ Abortion (criminal). ❻ Alcohol.

Answer 111

**Lack** of reasonable **medical skills** (failure to follow the basic medical principles which are not a subject of any discussion).

Answer 112

Incompetence leads to minor or fatal mistakes about which the practitioner is responsible about.

Answer 113

Specialists are obligated to update their information and skills for the best practice

Answer 114

- **Lack** of reasonable **care** in **diagnosis, treatment & follow up** which may result in **serious bodily injury (harm/loss)** **OR** - **Death** of the patient (omission or commission)

Answer 115

- Where the standard of **medical care** given to a patient is considered to be **inadequate**. - A physician who very **competently delivered the wrong care**, however, would also be likely to be found to have been negligent, if their patient had harm or injured.

Answer 116

❶ Leaving towels and instruments after operations. ❷ Prescription overdose of a known toxic substance.

Answer 117

❶ A hospital is liable at law for the negligence of its employed nurses and radiographers. ❷ Doctors are legally responsible about the act of their assistants in his private practice.

Answer 118

- Delay in diagnosis - Diagnostic error - Therapeutic misadventures (drugs and physicians liability) - Inadequate care and follow up by medical and hospital personnel - Delayed recognition & improper treatment of medical & surgical complications

Answer 119

**Anaphylactic shock:** acute life threatening reaction including shock, cardiac arrhythmias, cardiac arrest, laryngeal oedema with shocking and respiratory failure. **Drug interaction:** between multiple prescribed drugs. **Teratogenic effect:** mainly in the 1st trimester leading to fetal malformation.

Answer 120

- anaphylactic shock, haemorrhage, cardiac and respiratory failure.

Answer 121

- The surgeon is responsible about the act of assistants and nurses as long as they act under his direct supervision **EXAMPLE:** forgetting of towels & instruments inside the patient.

Answer 122

❶ Proper examination for medical fitness (mainly heart & lungs). ❷ Proper investigations for blood & urine to exclude diseases. ❸ Removal of dentures before operations.

Answer 123

❶ Adequate observation of vital signs & conscious level. ❷ Proper preparation of the theatre, working apparatus & proper circuits.

Answer 124

❶ Proper care and follow up during recovery from anaesthesia.

Answer 125

- Contributory negligence - Composite negligence - Corporate negligence

Answer 126

- Any **unreasonable conduct**, or **absence of ordinary care** on **part of the patient or his attendant**, which **combined with** the **doctor’s negligence** contributed to the **injury complained of, as a direct cause** and without which the injury would not have occurred.

Answer 127

- Yes, in civil cases But not in criminal cases - The doctor has to **prove patient’s negligence,** But, the physician is expected to foresee that the patient may harm himself and to warn according

Answer 128

❶ Patient did **not give proper history** ❷ **failure to follow doctor’s instructions** regarding drugs, tests& diet ❸ **Leaving the hospital** against doctor’s advice.

Answer 129

Damages awarded by the court may be reduced.

Answer 130

- Injury is caused to the person without any negligence on his part, a result of the **combined effect of the negligence of some other persons (two or more).**

Answer 131

**each wrong person** is jointly and severally liable to the injured for payment of the entire damages,

Answer 132

the injured person has the choice of proceeding **against all or any of them.**

Answer 133

- It is the **failure** of those in **hospital administration/ management** who are responsible for **providing the treatment, accommodation and facilities necessary to carry out the purpose of the institution**, to follow the established standard of conduct.

Answer 134

❶ Provides **defective equipment or drugs**. ❷ Selects or retains **incompetent employees** including doctors. ❸ Fails in some other manner to **meet the accepted standard of care**, and such failure results in injury to a patient to whom the hospital owes a duty.

Answer 135

❶ There was negligence or incompetence from him. ❷ Patient suffered from a harm or damage. ❸ This damage is proved to be **resulted from this negligence or incompetence**.

Answer 136

It is a legal term which defines a **less than ideal outcome** that is **unrelated to the quality of medical care** delivered by the health care team.

Answer 137

❶ **Medical & surgical complications** that **can be anticipated** and represent **unavoidable** risks of appropriate medical care ❷ **Complications** that arise **unpredictably and are unavoidable**. ❸ **Complications** that arise as a result of **decisions made by patient and doctor with fully informed consent** but appear, in retrospect, to have been a less appropriate choice.

Answer 138

- The doctor in charge must **request an efficient attorney** in case of alleged malpractice & **should ask for help in the medical syndicate.**

Answer 139

- One of the expected risks follows an operation takes place or some known complications occur which lessens the benefit that was hoped .for, he makes an error of judgment - Moreover, the doctor is not responsible if the patient does not respond to the treatment.

Answer 140

- is a situation where a person **not intending to do unlawful act**, **does so** because of **wrong conclusion or understanding of fact**.

Answer 141

**Don’t use personal** social networking or social media sites such as Facebook to interact with patients.

Answer 142

Any interactions should occur in the context of a **physician– patient relationship.**

Answer 143

**Providers are warned of:** - The risks of postings being **disseminated beyond the intended audience** - Remarks being **taken out of context or misconstrued** - Content being **permanently accessible.**

Answer 144

- Telemedicine is the **practice of medicine over a distance**, in which **Interventions, Diagnoses therapeutic decisions, subsequent treatment recommendations** are **based on patient data, documents and other information** transmitted through telecommunication systems or video-conferencing tools.

Answer 145

❶ Store and forward ❷ Remote monitoring ❸ Real-time interactive services

Answer 146

-It **surpasses the need** for the medical practitioner to **meet in person** with a patient. - Instead, **data** such as medical images or biosignals can be **sent to the specialist as needed** when it has been acquired from the patient.

Answer 147

This practice is common in the medical fields of: - Dermatology - Radiology - pathology.

Answer 148

- Also known as **self-monitoring or self-testing.** - It uses a **range of technological devices** to **monitor health and clinical signs** of a patient remotely.

Answer 149

This is extensively used in the management of chronic diseases such as: - cardiovascular - disease diabetes - mellitus asthma

Answer 150

Interactive services can provide **immediate advice** to patients who require medical attention.

Answer 151

Tele neuropsychology

Answer 152

- There are several different mediums utilized for this purpose, including: 1. Phone 2. Online 3. Home visits. - A medical history and consultation about presenting symptoms can be undertaken, followed by assessment similar to those usually conducted in face-to-face appointments.

Answer 153

- It has the potential to improve health care but **must be consistent with in-person services and ethical rules which respect:** - Patient-physician relationship - Autonomy - Privacy/Confidentiality - Quality of care are mandatory.

Answer 154

- Therapeutic relationship - Formal relationship

Answer 155

- A doctor is **free to accept or refuse** to treat a patient **except in emergencies**.

Answer 156

emergencies

Answer 157

❶ Beyond his **practicing hours.** ❷ Not belonging to his **s**pecialty or beyond the competence and qualification. ❸ Doctor or any other family member is **i**ll. ❹ Doctor having important **s**ocial function in family. ❺ Doctor having **a**lcohol. ❻ Patient is **m**alingering ❼ Patient has been **d**efaulting in payment. ❽ Patient or his relatives are **a**busive/uncooperative. ❾ Patient refuses to give **c**onsent. ❿ An unaccompanied minor or **female** patient. ⓫ When doctor remains engaged with an **e**mergency or more serious case.

Answer 158

- A **third party** has **referred the patient** for **medical examination**; e.g: ❶ Pre-employment. ❷ Insurance policy. ❸ Yearly medical checkups. ❹ Cases of rape or victims of crimes or Medico-legal cases. ❺ In certain psychiatric illnesses referred by court/ police.

Answer 159

- Doctor has to **comply with the directive of the party demanding such examination**.

Answer 160

- Right to **choose his patient**, but not in emergency - Right to **use title and description of the qualification** to his name - Right to **practice medicine** - Right to **dispense medicine** to his patient - Right to **possess and supply dangerous drugs** to his patients - Right to **issue medical certificates and medico-legal reports** - Right to **recovery of fees**, if the patient does not pay the justified fees, help of court can be taken - Right for **appointment in public & local hospitals**

Answer 161

**❶ A**ccess to **health care facilities** and emergency services **❷ C**hoice: To choose **his own doctor** freely. **❸ C**ontinuity: To receive **continuous care**. **❹ C**omfort: To be **treated in comfort** during illness and follow-up. **❺ C**omplaint: Right to **complain** and redressal of grievances **❻ C**onfidentiality: All **information** about his illness **should be kept confidential** **❼ D**ignity: To be **treated with care, compassion, respect without any discrimination.** **❽ P**rivacy: to be treated **in privacy** **❾ R**efusal: Can **refuse any specific or all measures**. **❿ R**ecords: Can have **access to his records** and demand summary or other details

Answer 162

❶ He should **furnish the doctor with complete information** about the facts & circumstances of his illness ❷ He **should strictly follow the instructions of the doctor** as regards diet. medicine & lifestyle ❸ He should pay a **reasonable fee** to the doctor

Answer 163

- General duties - Duties of Physician towards State (Compulsory duties) - Duties of a Physician towards Patients - Duties of a Physician in Consultation - Responsibility of Physicians towards Each Other

Answer 164

- **Character** of physician - Maintaining good **medical practice** - Maintenance of **medical records** - Display of **registration numbers** - Use of **generic names** of drugs - Highest **quality assurance in patient care** - **Payment** - **Evasion of legal restrictions**

Answer 165

- A physician should **uphold the dignity & honor of his profession** and render **service to humanity** - reward or **financial gain** is a **subordinate consideration**.

Answer 166

- Improve medical knowledge and skills (up to date)

Answer 167

- Physician should **maintain the medical records for 3 years** from the date of treatment. - On **request for medical records**, they should be issued within the period of **72 h**. - He should **maintain a register of medical certificates issued**.

Answer 168

- Physician should **clearly display his fees** in his chamber and/or hospitals he is visiting.

Answer 169

- Physician should **observe the laws of the country** in regulating the practice of medicine

Answer 170

- Poisoning cases - Notification - Responding to emergency military service as & when required

Answer 171

- Assist police to know **whether poisoning is accidental, suicidal or homicidal**. - Death **certificate** should **mention poisoning & recommend PM examination**.

Answer 172

- Doctor is bound to **give information of communicable diseases, births, deaths & outbreak of an epidemic** to public health authorities.

Answer 173

- Exercise reasonable degree of skills & knowledge (competent) & should not guarantees cure or an assured improvement. - Attendance & examination - Prescribe proper and suitable medicines - Instructions - Prognosis - Control and warn - Third parties - Consent - Investigations - Emergency cases - Professional secrecy/ confidentiality

Answer 174

- When a doctor **agrees to attend a patient**, he is **under an obligation to attend to the case**, as long it requires attention. - If the doctor is **called by police to attend a case of road side accident**, he may give **first aid and advice**, but no doctor-patient relationship is established.

Answer 175

- he may give **first aid and advice, but no doctor-patient relationship is established**.

Answer 176

- Doctor should **give full instructions to his patients** or their attendants regarding use of medicines (quantities and timings) and diet.

Answer 177

- The **patient or his relatives should have such knowledge of the patient's condition** as will serve the best interests of the patient and the family.

Answer 178

- Doctor should **warn** patients of the **side-effects of prescribed drug**

Answer 179

- If a patient suffers from an **infectious disease**, the doctor **should warn not only the patient, but also third parties** who are close to the patient.

Answer 180

- A **mentally sound adult (> 21 years in Egypt) must be told of all the relevant facts in non-medical terms and in a language the patient understands and then obtain consent**.

Answer 181

- For **proper diagnosis & to know the progress**, the doctor **should advise investigations**, like biopsy, X-rays, etc.

Answer 182

- He has **moral, ethical and humanitarian duty to help the patient in saving his life**.

Answer 183

- The doctor is **obliged to maintain the secrets** - **Disclosure** would be **failure of trust and confidence**.

Answer 184

- **Consultation for patient's benefit** is of foremost **importance** - **Unnecessary consultations** should be **avoided**. - **Consultation is advised with a specialist** in some cases

Answer 185

❶ In case of **emergency**. ❷ If the **patient requests** consultation. ❸ In cases where **diagnosis remains obscure**. ❹ In connection with **organ transplantation**. ❺ When treatment or operation **involves risk of life**. ❻ When an **operation involves mutilation or destruction of an unborn child**. ❼ To take **decision about termination of pregnancy case, after 12 weeks and upto 20 weeks of pregnancy**.

Answer 186

- **No insincerity, rivalry or envy** All respect should be observed towards the physician in-charge of the case - **Consultant not to take charge.** - **Appointment of substitute:** A physician should accept to attend another physician's patients during his temporary absence from his practice

Answer 187

- Physician should **display the registration number** accorded to him by the SMC in his clinic & in all his prescriptions, certificates, money receipts given to his patients. - Physicians should **display as suffix to their names only recognized medical degrees** or such certificates / diplomas & memberships / honors which confer professional knowledge