Legal and ethical issues Flashcards
What is the ICF (International Classification of Functioning, Disability and Health)?
The ICF Checklist is a practical tool to elicit and record information on the functioning and disability of an individual- this information can be summarized for case records
What is a lasting power of attorney?
Allows patient to transfer their decision making should they lose capacity
Capable adults appoint person(s) ahead of time to make decision for them lest they be unable to do so themselves
Two varieties- Property/Financial affairs and Health/Welfare
Must be registered with the Office of the Public Guardian to be used
Health & welfare LPAs can only be used with people once they are unable to make their own decisions
What is an independent mental capacity advocate service (IMCA)?
Needed when nobody willing to advocate for them, lack capacity and major medical decision (including DNAR) or long term placement proposed
Only has the right to speak up for the patient, not to make decisions
Duty to seek advice in connection with serious medical treatment
Duty of NHS bodies/local authorities to seek advice before placement
What is the deprivation of liberty safeguards (DOLS)?
Article 5 of the Human Rights Act states that ‘everyone has the right to liberty and security of person- no one shall be deprived of his or her liberty [unless] in accordance with a procedure prescribed in law’
Aim to protect people who lack capacity from being inappropriately deprived of their liberty
To ensure patient being managed in least restrictive manner possible- provides us with no additional powers, but is to protect vulnerable patients from unchallenged institutions
Needed when patient lacks capacity, under continuous supervision and control in an institution and not free to leave for significant length of time
Put in place to make sure that a place only restricts someone’s liberty safely and correctly- is only done
when there is no other way to take care of that person’s safety
What are there positives of disclosing diagnosis of dementia?
Helps ascertain treatment preferences Make a Will/LPA/Advance Directive Helps plan for disability Avoids danger of colluding with family “a right to know” their diagnosis Better support and access to help psychological adjustment
What are the diagnosis disclosure suggested guidelines?
Use a multi-professional approach to answer questions and make recommendations
Consider telling patient and carer together
Allow each separate time to talk and ask questions
Arrange follow-up meetings to continue discussions
Discuss how the disease might progress
Agree a care plan
Provide written educational materials
Provide a list of community resources and contacts
Arrange for further support, e.g. supportive counselling
What are the rules for people driving with dementia?
Driving is a complicated task and the skills required and not simply correlated with a simple test of cognitive function- such as MMSE
Certain aspects of cognitive functioning will be more likely to lead to problems with driving eg. visual- spatial deficits, impaired judgement and executive functioning
Collateral history helps eg. carer view or accident
What is the SAFE DRIVE checklist?
Safety record Attention skills Family report Ethanol use Drug use Reaction time Intellectual impairment Vision and visuospatial function Executive functions
Who does the patient have to inform when they receive a diagnosis of dementia?
Legally obliged to tell DVLA and insurance company (or risk fine up to £1000) when given a diagnosis of dementia or a doctor advices them of the likelihood
DVLA will undertake investigations
Ask for GP & psychiatric records
May need driving assessment
2 possible outcomes- new licence valid for 1yr or licence revoked
