law Flashcards
what are torts
wrongful acts
what is bolam
accepted current practice
what is bolitho
evidence based medicine + logical
laymen doctrine of occupier’s liability
legal duty to ensure that pt are reasonably safe from harm by keeping the place safe, warning them of the dangers and taking care of special populations
laymen doctrine of vicarious liability
- employer held legally responsible to compensate pt who suffered damages caused by employee’s actions
- encourages employers to supervise more to make sure no accidents happen
what are independent contractors
- hired from outside the organisation to get shit done and the organisation has no say on how the contractors get shit done
- e.g. hiring specialists
breaking down the sources of law in SG
1) legislations/statues
- healthcare services act 2000
- misuse of drug act
- infectious diseases act
- infectious diseases (Covid-19 - stay orders) regulations 2020
- penal code 1871
- personal data protection act
- mental health (Care and treatment) Act
2) common/case law
- case precedents
- decision of judges - law report
criminal law
- reference sources: legislations, statutes
- guilty/not guilty
- burden of proof = 100% beyond reasonable doubt
- guilty = sentence to fine, caning, jail term and or death
civil law
- reference: contract law/law of torts
- liable/not liable
- burden of proof = 51% (balance of probabilities)
classification of liabilities
1) criminal liability
2) civil liability
- tortiously liable: civil wrong/torts that breaches duty imposed by law to prevent harm to others (negligence, intentional wrongdoing, strict liability)
- contractually liable: breaches of contractual obligations or agreements between parties (legally binding)
tldr of the principles of medical ethics
1) Autonomy
2) beneficence
3) non-maleficence
4) justice
5) fidelity
6) veracity
medical ethics - autonomy
- respect for pts needs, desires, preferences
- every human has unconditional intrinsic value and capacity for rationale choices
- autonomous pt has freedom to form own judgement and choose own actions even if others think its wrong so its important to inform on pros and cons
- cases where autonomy is absent: coercion, ignorance, immaturity, mental incapacity
- legal considerations
1) mental capacity act
2) Gillick awareness/competence
3) lasting power of attorney (appoint people to make decisions on their behalf)
4) court-appointed deputy
5) mental health (Care and treatment) Act
beneficence - medical ethics
- contribute to pt’s welfare and well-being
- HCP do good to pt and general public
- elements: do not harm, prevent harm, remove harm, do/promote good
non-maleficence - medical ethics
do no harm
justice - medical ethics
- equitable distribution of benefits/burdens
- equal access to all programmes
fidelity - medical ethics
- truthfulness & confidentiality
- exceptions:
1) pt consent
2) to other HCP providing care for pt
3) statutory duty (all the acts)
4) disclosure under court order
5) discovery of document in court preceding
6) public interest
veracity - medical ethics
honesty
Litmus test
doing the right thing even when no one is looking
medical negligence
- failure to exercise an acceptable standard of care leading to damage
- never do properly
- never do what was supposed to be done
- did stuff not supposed to be done
negligent misstatements
- if you know information was required for contemplation
- if you know that it would be communicated
- if you know that pt will rely on the info
- if pt does rely on the info
what is bolam test
not negligent if acted in accordance with practice accepted as proper
what is bolitho case
court satisfied that exponents of body of professional opinion has logical basis, supported by proven facts
general outline for establishing case for medical negligence
1) duty of care
2) breach of standard of care
3) Causation
4) foreseeable damages/injuries
establishing case for medical negligence - duty of care
- established when pt receive treatment/advice
- both doctrines
- may be further owed to third parties so they do not sustain injuries
- neighbour principle: duty to ensure one’s act does not cause foreseeable harm to another
establishing case for medical negligence - breach of standard of care
- reasonable man’s test
- bolam test supplmented by bolitho case and confirmed by gunapathy
establishing case for medical negligence - causation
- establish lack of care resulted in pt injury
- pt’s defence
** Res ipsa loqiutor: facts speak for themselves
** law helps pt where it is unfair or difficulty to identify errors - HCP defence
** Volenti non fit injuria: consented to risk
** contributory negligence: pt contributed to harm through own negligence + HCP negligence then damage reduced - pt rights
establishing case for medical negligence - foreseeable damages/injuries
damage/loss/injuries must not be too remote if not it will be unreasonable foreseeable
composition of complaint panel (CP)
3 groups of people
1) not less than 5 council members from SPC
- serve 3 year term, eligible for reappointment
2) 10 - 40 senior registered pharmacists
- 2 yr term, eligible for reappointment
- not SPC members
- at least 10 years and standing
3) 6 to 40 laypersons nominated by minister
- serve 2 yr term, eligible for reappointment
- not pharmacist
** all complaints go through chairperson first
what does the complaints committee (CC) do
- look into complaints brought against pharmacist
- determine if
1) Sanctions needed against pharmacist
2) complaint inquiry need to be referred to disciplinary committee or health committee
what is the composition of the complaints committee (CC)
1) 1 chairman (SPC member)
2) 2 registered pharmacist (10 year standing, >/=1 council member)
3) 1 layperson
complaints committee (CC) functioning
- all members present to form quorum for CC meeting
- all members have equal votes, chairperson has casting vote
- decision/resolution in writing and signed by all members of the committee
- seek legal advice if necessary
inquiries by complaints committee (CC)
- completed within 3 months
- call upon any person deemed necessary to assist
- require production of document/record related to subject matter
- require registered pharmacist to give all information related
- may call registered pharmacist to answer (in writing) any allegations
- registered pharmacist does not have the right yo be heard by CC unless allowed at its discretion
determinations of complaints committee (CC)
1) if formal inquiry not required
- warning letter: can appeal within 30 days
2) if formal inquiry required
- refer to DC or HC
what does the disciplinary committee (DC) do?
conduct formal inquiries
composition of disciplinary committee (DC)
1) >/= 3 registered pharmacists (> 10 years standing), >/= 2 SPC members
2) 1 chairman (SPC)
3) 1 layperson (no voting rights, don’t need to be present all the time)
inquiry of disciplinary committee (DC)
- detailed representation by both council and pharmacist (can be in person or represented by council)
- if giving evidence then legally bound to tell the truth
- make finding within 6 months from date of appointment
determinations of disciplinary committee (DC)
1) if convicted
- can remove from register
- suspend from register
- restrict practice not more than 3 yrs
- impose penalty not more than 50k
- issue warning
- any orders that DC deems appropriate
2) when to refer to HC
- DC find that matter touches physical/mental health of pharmacist
- if HC feels that fitness of pharmacist is an issue
**can appeal within 30 days after DC to make decision
what does the health committee (HC) do?
- determine physical and mental fitness of pharmacist to practice
- receive inquiry case from complaints panel
composition of health committee (HC)
- min 3 SPC members
- 2 yrs term, eligible for reappointment
determinations of health committee (HC)
if impaired cuz of physical/mental condition then
- order pharmacist to pay cost
- order suspension not more than 12 months
- order conditional registration for not more than 3 yrs upon compliance
- removed from register
** can appeal within 30 days after decision made
what does the interims orders committee (IOC) do?
- determine if pharmacist need to be suspended to protect public or in public interest
- can receive referral of complaints from anyone on the recommendation of chairman of complaints
composition of interims orders committee (IOC)
3 SPC members independent of DC, HC
inquiry of interims orders committee (IOC)
require registered pharmacist to be present or represented by counsel
determinations of interims orders committee (IOC)
- decisions made by majority of votes
- suspension from register not more than 18 months
- conditional registration not more than 18 months
- after IOC make decision pharmacist can appeal to high court
7 developmental framework for pharmacist
1) expert professional practice
2) building working relationships
3) leadership
4) management
5) education, training, development
6) research and evaluation
7) professionalism
how long is the total duration for prereg for a pharmacist
12 months
what are the requirements for a foreign pharmacist to practice in SG
- graduated from SPC recognised uni
- undergo period of training min 3 months under supervision of registered pharmacist in SPC approved place
- sit and pass for forensic and competency test
what are the requirement of renewing license
mandatory continuing professional education (CPE): 50 CPE points over 2 yrs
