Legal Framework / Ethics Flashcards
pre-disposing risk factors for child abuse
Disability Learning difficulties Behavioural problems adoption Looked after children parental mental health issues parental drug / alcohol issues domestic violence parental previous abuse as a child socio-economic deprivation parental unemployment
What components are required for valid consent in medicine
provision of information
capacity
consent given voluntarily / non-coerced
five key principles of the mental capacity act
1 - presumption of capacity
2 - Individuals should be given all practicable help before treating them as not being able to make their own decisions
3 - People have the right to make decisions that others might regard as unwise or eccentric
4 - act in their best interests
5 - least restrictive option
Who has parental responsibility for a child?
A mother automatically has parental responsibility from birth
A father has parental responsibility if he’s either:
- married to the child’s mother at birth
- listed on the birth certificate (after 15/4/2002)
what is Gillick Competence
A test to determine if a child <16yo can consent to treatment or investigation
Components of Gillick competence
They must have - sufficient understanding / intelligence to understand the proposed treatment or investigation Including: - purpose - nature - effects - risks - likelihood of success - availability of other options
Can Gillick competence be applied to <13yo
yes - no lower age limit
However, rarely appropriate or safe for <13yo to consent to treatment without parental involvement
Age of sexual consent in UK
16 yrs
E, S + W
what is the law regarding statutory rape
<13yo cannot consent to any sexual activity
Must be passed on to safeguarding regardless of Gillick competence
What are the Fraser Guidelines
and what are they for
Used in relation to contraception and sexual health only
1) YP can understand the nature and implications of treatment
2) YP cannot be persuaded to tell their parents / doesn’t agree for the HCP to inform them
3) Likely to begin or continue sexual activity regardless of treatment
4) physical / mental health likely to suffer unless advice or treatment is received
5) advice / treatment is in the YPs best interests
What are the main elements of clinical governance
Risk management
Education / training / CPD
Clinical audit
Clinical effectiveness
Information management and communications
patient / public involvement
strategeic leadership / workforce planning
define public health
The science of: preventing disease prolonging life promoting health preparing for disaster via organised efforts and education of individuals, societies, organisations and groups
What is epidemiology
study of distribution and determinants of health related states
among specific populations
and applying that to control of health problems
define clinical governance
A systematic approach to safeguarding and maintaining quality in healthcare
- accountability
- integrated approach
- creating and enabling environment
Define clinical audit
a quality improvement process seeks to improve patient care and outcomes through systematic review of care against explicit criteria or standards and implementing change
Explain the difference between research and audit
Research = finding an answer to a question - often by comparing groups
audit = ensure practice meets existing standards set by existing knowledge
Research = finding the right thing to do Audit = ensuring the right thing is done
Steps of the audit cycle
1) identify problem
2) set standards
3) assess or measure quality
4) identify change needed
5) implement change
6) monitor effects of change
How can healthcare be measured
- Efficacy (does it work)
- Effectiveness (how well does it work)
- Efficiency
- Equality / equity
- Accessibility
- Acceptability
- Appropriateness (meeting needs)
criteria for screening programmes
disease is important in severity or consequences
natural history is known
acceptable treatment exists
suitable test with high sensitivity and specificity
test is acceptable
identifiable ‘at risk’ population to screen
Cost of screening
conintinuning process + good participation
Define domestic abuse
An incident or pattern of incidents
of controlling, coercive, threatening, degrading or violent behaviour.
Including sexual violence, honour based violence and FGM.
By a partner / ex-partner / family member / carer
Define discriminatory abuse
Ill treatment or harassment based on a persons
- age
- sex
- sexuality
- disability
- religious beliefs
- race
- marriage / civil partnership
- Gender reassignment
- Pregnancy and maternity
define financial abuse
Theft / fraud / coercion over finance or will
Misuse of someones money / property / belongings without their agreement
Define institutional abuse
Lack of dignity and respect for service useers
Through rigid regimes / systemic poor care / poor organisational culture / lack of resources / denial of choices
Define physical abuse
Hitting / pushing / burning / kicking / biting / hair pulling / rough handling / unreasonable restraint / locking someone in a room
define neglect
acts of omission by people giving care
including ignoring medical needs / physical needs / emotional needs
failure to provide access to appropriate healthcare / education
withholding necessities such as nutrition / heating / medication
define sexual abuse
rape / inappropriate touching / forcing someone to take part in or witness any sexual act against their will
define psychological / emotional abuse
intimidation / bullying / shouting / swearing / threatening / taunting / humiliating
what proportion of all violent crime reported in the UK is due to domestic abuse
1 / 4
90% affects women and children
Impact of domestic abuse on women
Physical injuries / death STIs Gynae issues / miscarriage / stillbirth / IUGR poor nutrition fatigue chronic pain psychological - anxiety / depression / suicidality PTSD / poor sleep Isolation low self worth drug and alcohol issues
Impact of domestic abuse on children
developmental delay poor educational attainment / truancy / disrupted schooling poor concentration / poor memory difficulties relating to others physical injuries enuresis / encopresis running away / homelessness psychological self harm teen pregnancy
Screening question examples for asking about domestic violence
Are you ever afraid at home
Has your partner ever hit you
Have you ever been forced to do anything sexually which you didn’t want to
safety plan suggestions for victims of domestic abuse
Avoid the kitchen / potential weapons when violence starts
provide info of people to go to if in danger
ask neighbours to call 999 if they hear anything which sounds like they are in danger
have a place to hide important phone numbers
teach children 999
keep passport / documents together somewhere accessible
let someone know about the abuse so it can be documented (e.g if going to court)
emergency bag in safe place
try to get proof of abuse e.g photos - if safe to do so
