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Year Three - Medical Ethics & Law > Medical Ethics & Law Principles > Flashcards

Medical Ethics & Law Principles Flashcards

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1
Q

What legal document governs medical law?

A

Medical Act 1858

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2
Q

Which organisation created the Medical Act 1858?

A

General Medical Council (GMC)

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3
Q

What authority regulates the GMC?

A

Professional Standards Authority

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4
Q

Which document provides doctors with ethical and professional guidance?

A

Good Medical Practice

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5
Q

Which document provides medical students with ethical and professional guidance?

A

Professional Behaviour & Fitness to Practise

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6
Q

What are the four principles of ethics?

A

Autonomy

Non-Maleficence

Beneficence

Justice

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7
Q

What is autonomy?

A

It means that a patient has the ultimate decision-making responsibility for their own treatment - only if they have capacity

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8
Q

What should you do if the patient asks for a treatment the doctor considers would not be of benefit?

A

They don’t have to provide the treatment

They should explain their reasons to the patient and explain other options that are available, including the option to seek a second opinion

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9
Q

What is non-maleficence?

A

It states that a medical practitioner has a duty to do no harm or allow harm to be caused to a patient through neglect

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10
Q

What is beneficence?

A

It means that all medical practitioners have a moral duty to promote the course of action that they believe is in the best interests of the patient

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11
Q

What is justice?

A

It is the principle that when weighing up if something is ethical or not, we have to think about whether it’s compatible with the law, the patient’s rights, and if it’s fair and balanced

It also means that we must ensure no one is unfairly disadvantaged when it comes to access to healthcare

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12
Q

What is consent?

A

It is when a patient gives permission before receiving any form of medical treatment, examination or test

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13
Q

Who obtains consent?

A

It must be obtained by a clinician with appropriate experience and expertise

For example, a junior doctor cannot obtain consent for a procedure that they themselves cannot conduct, or don’t know the full benefits and risks of

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14
Q

How do we obtain consent?

A

You must listen to the patient and respect their views about their health

You must discuss with patients their diagnosis, prognosis and treatment

You must share with patients the information they want or need in order to make decisions

You must maximise patients abilities to make decisions for themselves

You must respect the patients decision

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15
Q

In what four circumstances do we not need to obtain consent?

A

When an individual requires emergency treatment to save their life, however they’re unconscious

When an individual requires emergency treatment, however it would be unsafe to wait to obtain consent

Severe mental health conditions

When there is a risk to public health - rabies, TB, etc

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16
Q

What type of consent is obtained for non-invasive treatments (blood pressure, ECG)?

A

Implied consent

Verbal agreement

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17
Q

What type of consent is obtained for minor or routine investigations (blood letting, IV access, ABG)?

A

Express consent

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18
Q

What type of consent is obtained for high risk procedures (surgery)?

A

Written consent

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19
Q

What are the three criteria for consent?

A

Voluntary - which means that the decision to give consent is not influenced by pressures of relatives, friends or healthcare professionals

Informed - which means that individuals are provided with information about the benefits, risks and consequences if the treatment didn’t go ahead

Capacity

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20
Q

What is the most important consideration regarding the information in informed consent?

A

It must be understood by the patient

21
Q

What is capacity?

A

Capacity is the ability to give consent

It relies on the patient being able to understand, believe, retain and weight the necessary information

22
Q

What rights are given to the patient if they have capacity?

A

They can make their own decisions to refuse treatment, even if those decisions appear irrational to the doctor or may place the patient’s health or their life at risk

23
Q

Is capacity situation specific?

A

Yes

It can fluctuate due to different decisions and timeframes

24
Q

What are the five obstacles of capacity?

A

Mental capacity

Intoxication (alcohol, drugs)

Unconsciousness

Communication difficulties

Age

25
Q

What legal document governs capacity in Scotland?

A

Adults with Incapacity Act 2000

26
Q

What legal document governs capacity in England and Wales?

A

Mental Capacity Act 2005

27
Q

What does the ‘Adults with Incapacity Act 2000’ outline in regards to capacity?

A

The legislation sets out the criteria and procedures to be followed in making decisions when patients lack capacity to make these decisions for themselves

It also grants legal authority to certain people to make decisions on behalf of patients who lack capacity

28
Q

What does it mean if the ‘Adults with In capacity Act 2000’ deems an individual not to have capacity?

A

They are incapable of acting on/making decisions about their healthcare

29
Q

What are the five principles of the ‘Adults of Incapacity Act 200’?

A

Principle 1 - any action or decision taken must benefit the person

Principe 2 - it must be the least restrictive option

Principle 3 - take account of the wishes of the person

Principle 4 - consult with relevant others

Principle 5 - encourage the person to use existing skills and develop new skills

30
Q

What is a power of attorney?

A

This is a means by which individuals, whilst they have capacity, can grant someone they trust powers to act as their continuing and/or welfare attorney

31
Q

How many people can be appointed as power of attorney?

A

More than one

32
Q

What is the rights of a continuing power of attorney?

A

They can continue or commence on the granter’s loss of capacity

33
Q

What is the rights of a welfare power of attorney?

A

They only come into effect in the event of the granter’s loss of capacity

34
Q

Who do power of attorneys register with?

A

Public guardian

35
Q

What happens if a person does not have capacity and they have not appointed a lasting power of attorney?

A

The healthcare professionals treating them can administer treatment if they believe it’s in the person’s best interests

The clinical must discuss this with the person’s relatives and friends before making this decision

If an agreement cannot be reached between family and clinicians, the case may be taken to court

An incapacity certificate which states the nature of incapacity, its expected duration and the intended treatment should be completed

36
Q

How do we manage patients who lack capacity due to temporary intoxication by drugs/alcohol or unconsciousness?

A

If possible wait until the patient has sobered up/regained consciousness before commencing treatment

In a life-threatening situation, healthcare professionals may act on the behalf of the patient to perform a procedure in their best interest

37
Q

How do we manage patients who lack capacity due to communication difficulties?

A

We can liaise with the next of kin

We can use braille information and consent forms

We can use sign language interpreters

We can use interpreters via telephone or in person

38
Q

At what age do we assume individuals have capacity unless proven otherwise?

A

> 18 years old

39
Q

At what age do we assume that individuals can make decisions about their health independently from their parents and are usually able to consent for themselves?

A

16 - 17 years old

40
Q

How do we assess if individuals who are 16 have capacity?

A

We conduct the Gillick competency assessment

41
Q

When can consent be overruled in young people? Who overrules this?

A

If a young person refuses treatment, which may lead to their death or a severe permanent injury

Court of Protection (parents can however it is usually best to go through the courts)

42
Q

Which five individuals can consent on a child’s behalf?

A

The child’s parents

Legally appointed guardian

Local authority designated to care for the child

A person with a residence order concerning the child

A local authority/person with an emergency protection order for the child

43
Q

What is the duty of candour?

A

This means that you must be open and honest with patients when something goes wrong with a patient’s treatment or care which causes, or has the potential to cause, harm or distress

It also means you are open and honest with all parties as well as any relevant organisations - such as the employer, practice principle, health authority

44
Q

What is confidentiality?

A

It requires doctors, and other healthcare professionals, to keep their patients’ information private within the healthcare team, apart from some very specific circumstances

45
Q

In what eight circumstances can doctors breach confidentiality?

A

When individuals have consented

With other health care professionals involves in the patient’s care

Where not sharing the patient’s information puts the patient, or others, in danger

Where the patient lacks capacity and sharing information is of overall benefit to the patient

When the clinician suspect signs of child abuse

When it is in the public’s interest (terrorism, murder, homicide, rape)

When the clinician is defending themselves against negligence claims in court

When directed to by a court of law

46
Q

In terms of deceased patients, when can confidentiality be breaches?

A

Medical Certificate of Cause of Death

47
Q

What are the eight principles of confidentiality in the GMC?

A

Use the minimum necessary personal information

Manage and protect information

Be aware of your responsibilities

Comply with the law

Share relevant information for direct care

Ask for explicit consent

Tell patients

Support patients to access their information

48
Q

What are the five GDPR regulations which apply to confidentiality?

A

The data subject has given explicit consent

The processing is necessary to protect the vital interests of the data subject or another person in a case where the data subject is physically or legally incapable of giving consent

The processing is necessary for reasons of substantial public interest

The processing is necessary for reasons of public interest in the area of public health

The processing is necessary for archiving purposes in the public interest, scientific or historical research purposes or statistical purposes

49
Q

Which GDPR article applies to medical practice?

A

Article 9

Year Three - Medical Ethics & Law (5 decks)

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