MEDICAL ETHICS II: Genetic Controversies; Beginning of Life; Complaints; MH Legislation

Question 1

To be aware of some of the ethical implications associated with Pre natal Diagnosis

Answer 1

a

Question 2

Implications for gene testing

Answer 2

HD:
* + or - result
* insurances
* impactr on self, family, work

Question 3

Prenatal diagnoses and screening

Answer 3

• increased nuchal fold USS
• prenatal testing dt maternal age and fold measurements
• consider risks of testing and sampling

Question 4

HFEA 2008

Answer 4

most recent amendment to HFEA

An Act to amend the Human Fertilisation and Embryology Act 1990 and the Surrogacy Arrangements Act 1985; to make provision about the persons who in certain circumstances are to be treated in law as the parents of a child; and for connected purposes.

Question 5

HFEA full

Answer 5

ensure that all human embryos outside the body—whatever the process used in their creation—are subject to regulation.

ensure regulation of “human-admixed” embryos created from a combination of human and animal genetic material for research.

ban sex selection of offspring for non-medical reasons. This puts into statute a ban on non-medical sex selection currently in place as a matter of HFEA policy. Sex selection is allowed for medical reasons—for example to avoid a serious disease that affects only males.

recognise same-sex couples as legal parents of children conceived through the use of donated sperm, eggs or embryos. These provisions enable, for example, the civil partner of a woman who carries a child via IVF to be recognised as the child’s legal parent.

retain a duty to take account of the welfare of the child in providing fertility treatment, but replace the reference to “the need for a father” with “the need for supportive parenting”—hence valuing the role of all parents

alter the restrictions on the use of HFEA-collected data to help enable follow-up research of infertility treatment.

Question 6

Understanding the NHS complaints procedure

Answer 6

• logical escalation
• TIME LIMIT = within 6mos otherwise assumed to be more than 12mos

OUTCOMES
* FRONTLINE RESOLUTION = early resolution
* INVESTIGATION 20days
*INDEPENDENT EXT. REVIEW

Question 7

Dealing with complaints

Answer 7

a

Question 8

Having strategies to reduce complaints

Answer 8

Join a Defence Organisation
Be aware of and follow the GMC’s Advice, “Good Medical Practice”
Be aware of the local complaints procedure / deal with complaints expeditiously
Put patients first and always try to act in their best interests
Do not be judgmental
Do not be afraid to refer or get a second opinion
Clinical Audit
Peer Review
Act responsibly
Do not break the law

Question 9

Understanding the Patient Rights Act and the ramifications for the medical profession

Answer 9

Patient Rights 2011
- patient focussed; account needs
- optimum benefit
- participation of pt
- pt information and involvement

Question 10

Understanding “Public Interest’

Answer 10

a

Question 11

NHS Complaints Procedure 2017

Answer 11

• complaint procedure available and clear to pt.
• PERIOD OF 5D WHEN COMPLAINTS OFFICER CAN DECIDE WHETHER IT CAN BE DEALTH WITH INFORMALLY
• DOCUMENTATION
• 20d for full response
• 28d NHS Oombudsman

Question 12

Mental Health Compulsory Powers

Answer 12

Emergency detention certificate EDC
Authorises detention for up to 72 hours
- fully registered practioner

Short-term detention certificate STDC
Authorises detention for up to 28 days
- approved medical praactioner
+ named person consulted

Compulsory Treatment Order CTO
Authorises detention for up to six months
- application alongside REPORTSx2 (GP. & AMP)
+ care plan

Nurses holding power
Authorises detention for up to two hours

Question 13

Police Powers

Answer 13

Removal from a public place

Appears to be in immediate need of care or treatment to a place of safety

Detain for up to 24 hours = plan and assess

Question 14

Adults with Incapacity 2000

Answer 14

• intervention must benefit the adult
• least restrictive
• past and present wishes of adult
• views of relatives nad carers etc.

assess capacity by CURD
comm
undrstanding
retention
decision

Question 15

What does the AWI(S)A 2000 allow us to do?

Answer 15

Property
Welfare (Medical)
Financial
* indicated in PHYSICAL ILLNESS

• INTERVENTION ORDER
• GUARDIANSHIP ORDER

unideal
- forced detention
- cannot use MH act powers

Question 16

Advanced Directive

Answer 16

not statute
treatment you don’t want when incapacitated
Has to be specific to the situation
In writing
Still valid

Question 17

Advanced Statement

Answer 17

MH(C&T)(S)A
Treatment for MD that do or do not want when incapacitated
Dr to “give due regard” to
If override, write to the MWC with reason

Question 18

Adult Support and Protection (Scotland) Act 2007

Answer 18

• unable to safeguard their own well-being, property, rights or other interests;
• at risk of harm; and
• because they are affected by disability, mental disorder, illness or physical or mental infirmity, are more vulnerable to being harmed than adults who are not so affected.

*focus is self-harm or at VULNERABLE by the actions of others