Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MBBS - Year 1 > Medical Law > Flashcards

Medical Law Flashcards

1
Q

Purpose of the law

A

To establish and define standards of acceptable (e.g. respect for autonomy)
To maintain standards and punish ‘offences’
To protect the vulnerable (e.g. certain ‘consent’ cases must come before a court)
Above all – to achieve the resolution of disputes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Types of the law

A 
Criminal law 
Civil law (e.g. Contract & Tort)
Public law (e.g. Judicial Review (JR))
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Sources of law

A

Statute

Common law/ case law

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Statute - source of law

A 
Abortion Act 1967
Human Tissue Act 2004
Human Fertilisation & Embryology Act 1990
Human Rights Act 1998
Mental Capacity Act (MCA) 2005
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Common Law/ Case Law

A

Judge – made law based on a system of Precedent
Judgements made by higher courts (i.e. Supreme Court & Court of Appeal) have to be followed by lower Courts and in future cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Regulation and professional guidances

A

EU Directive – European Working tine Directive; consumer protection
GMC – licensing of doctors
Regulatory bodies – HSE, PHSO, Human Tissue Authority, HFEA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What must a pt establish to make a negligence claim

A
  1. That they were owed a duty of care
  2. That the duty of care was ‘breached’
  3. That they have sustained an injury (loss)
  4. Injury was ‘caused’ by that breach of duty (causation)

Must be within limitation period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Breach of duty

A

‘Failing to act in accordance w/ the standards of reasonably competent medical men acting in the relevant field at the relevant time’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Example of something that is not ethical but lawful

A

Under old Human Tissue Act (1961) patients agreed to retention of ‘tissue’ - but didn’t realise this could involve whole organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Example of something that is not lawful but ethical

A

Mercy killings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Advance decisions - MCA

A

Refusal of life saving treatment:
18+ and mentally competent
Must be in writing
Be signed and witnessed
Must be clear what treatment is being refused & under what circumstances
State clearly that the decision applies, even if life is at risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Where does the duty of confidentiality come from

A

Legal - HRA 1998, DPA 2008
Professional codes of conduct
Terms of employment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Tech problems causing confidentiality issues

A

Misdirected emails where 2 people have similar names
Email forwarding
Info lost, left somewhere or stolen e.g. unencrypted memory sticks, ward/team handover notes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Casual convo problems causing confidentiality issues

A

Many improper disclosures are unintentional

Patients in the public eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Social media problems causing confidentiality issues

A

GMC Doctors’ Use of Social Media (2013)
Facebook/ Twitter
Peer Group Forums

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Consequences of a breach of confidentiality

A

Serious persistent failure to follow GMC guidance puts your registration at risk
Criminal prosecution
Dismissal
Embarrassment and bad publicity for employer
Financial penalty for your employer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Who are entitled rot same duty of confidence as adults

A

Young people aged 16-17

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Sliding scale of competence

A

Younger you are, harder to demonstrate you have ability to make decisions for yourself; perverse – right to consent treatment but not deny

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What rights does a child have if they are Gilick competent

A

Rights of the child to have confidential advice and treatment more important than any rights of the patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are child <16 owed if they are not Gilick competent

A

A duty of confidentiality, which may not arise in practice due to inability of giving consent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Adults who lack capacity

A

Owed a duty of confidentiality
However, s4(7) MCA 2005 states that people who are in involved in their care should be consulted about their wishes and any relevant values and beliefs
Discussions must be limited and disclosures in the best interest of pt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Confidentiality and deceased pt

A

Generally considered that duty of confidentiality survives death
Circumstances in which relevant info has to be disclosed e.g. to assist coroner or when required by law

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Cases where you can breach confidentiality

A
  1. Consent of patient (implied or expressed)
  2. In the patient’s best interests
  3. Required by Law (statue and judge-ordered)
  4. For the protection of patients and others – ‘public interest’
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Breach confidentiality - consent

A

Pt must understand what Is to be disclosed and why

Disclosure kept to a minimum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Implied consent - confidentiality

A

Can disclose info to other members of the healthcare team and family unless pt has explicitly said not to

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Breaching confidentiality in the best interest of the pt

A

Emergency situations e.g in A&E

Only disclose relevant info

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Breaching confidentiality - law statute

A 
Public Health (Control of Disease) Act 1984 
NHS counter Fraud Investigations 
GMC – investigation of a doctor’s fitness to practice
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Breaching confidentiality in public interest

A

To prevent and support detection, investigation and punishment of serious crime
And/or prevent abuse or serious harm to others
Public good outweighs confidentiality obligations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Extent of disclosure in the public interest

A

Proportionate and limited to the relevant details
Each decision must be on its own merits
Wherever possible disclosure should be discussed w/ the individual concerned and consent sought
Record should be kept to show the circumstances in which the decision to disclose was made
Healthcare professionals should not see their role as police informants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Police and public interest discussion

A

Serious crime and national security e.g. murder, rape, treason, kidnapping or serious harm to the surety of the state or to public order, crimes involving substantial financial gain
Theft, fraud or damage to property where loss and damage is not substantial doesn’t warrant breach in confidence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Caldicott principles

A

Staff who have access to personal info should handle them as defined by the Caldicott principles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Responsibility of Caldicott Guardians

A

Safeguarding and governing the uses of patient information within the Trust and acting as the ‘conscience’ of the Trust

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Right of rectification

A

Data subjects have the right to correct data if it is inaccurate or incomplete

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Do clinical opinions count as inaccurate data

A

Even if it turns out not to have been correct, can allow a patient to add a note to records indicating that they disagree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Right of erasure

A

Allows an individual to request removal or deletion of personal data where the example the data is no longer necessary for the purpose it was collected
Doesn’t apply to healthy records

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What constitutes a battery

A

Performing the wrong operation
Ignoring a spp prohibition against treatment
Ignoring a withdrawal of consent e.g. continuing to ventilate a patient
Performing unnecessary treatment e.g. procedures that aren’t clinically indicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What constitutes valid consent according to DOH

A
  1. Patient must have capacity to consent to intervention
  2. Patient must be appropriately informed
  3. Must be given voluntarily – no under any undue influence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Key principles of MCA

A

PLUMB

Presumption of capacity
Least restrictive 
Unwise decisions
Maximise capacity 
Best interests
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Presumption of capacity - MCA

A

Most people can make some decisions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Least restrictive - MCA

A

Consider all the ways to promote rights and freedom

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Unwise decisions - MCA

A

Remember unwise is not the same as unable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Best interests - MCA

A

If an individual lacks capacity, any decision made/ actions taken must be made in their best interest (in a wider sense)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Stages of determining capacity

A

Stage 1 – is the patient suffering from an impairment of, or a disturbance in the functioning of, the mind or brain?
Stage 2 – does the disturbance/ impairment make a person unable to make decision for himself, at the time. Use a functional test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Functional test - capacity

A

a. To understand the info relevant to the decision
b. To retain that info; or
c. To use or weigh that info as part of the process of making the decision; or
d. To communicate his decision (whether by talking, using sign language or any other means)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Mental capacity and mental illness

A

A patient can still have mental capacity even where they have a mental disorder e.g. schizophrenia: Re C (Refusal of Treatment) [1994] – had gangrene and thought he was doctor so refused treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Temporary factors that can erode capacity

A

Shock, pain or drugs
Re MB [1997] – Needle phobia render a patient temporarily incapable of making a decision, needed C-section but was too afraid so doctors did it anyways and won case

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What should we do for pts who lack capacity

A

Section 1(5) MCA - If the patient lacks capacity to make a decision, clinicians must act in their ‘best interests’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Section 4 MCA

A

For patients who don’t have capacity

  • Encourage patient participation and find out their views by speaking to next of kin
  • Identify all the relevant circumstances e.g. religion
  • Avoid discrimination/ assumptions
  • Assess whether the patient will regain capacity
  • Does the decision concern life sustaining treatment?
  • Duty to consult others
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Material risk

A

Would a reasonable person in the patients position attach significance to it, or the DR knows that a patient would attach sig. to it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Considerations for material risk

A

Effect on that patient
The importance to the patient of the benefits/ desire to have treatment Alt. treatments available Risks associated w/ alt. treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Choosing reasonable alternatives to suggested treatment

A

Must know about procedure
Must be accepted practice
Must be an appropriate option, not a possible option
Not a variant of current treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Consent - undue influence

A 
Consent must be given voluntarily and freely, without pressure or undue influence - DOH
Re T (Adult: Refusal of medical treatment) [1992] – refusal of blood transfusion, undue influence from mother who was a Jehovah witness. Suffered haemorrhage and died
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Standard consent forms

A

Form 1 – adults or children w/ mental capacity
Form 2 – parental consent to treatment/ investigation of a child or YP
Form 3 – procedure spp consent form
Form 4 – adults who lack mental capacity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Negligence

A

Any act or omission which falls short of the standard to be expected
Part of civil law

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Examples of clinical negligence

A

Delayed diagnosis or misdiagnosis
Incorrect treatment
Surgical mistakes
Prescribing inappropriate medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Causation - negligence claims

A

The claimant must show the breach of duty caused (or materially contributed to) the harm or injury
The burden of establishing that the breach caused harm rests w/ the claimant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What does a Dr need to successfully defend a negligence claim

A

Call evidence that shows:
A reasonable body of doctors
Skilled in that particular speciality
Would’ve done just the same as the defendant doctor did
With the exception of consent cases the Bolam test is applied to all aspects of the doctor/ patient rship

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What should happen if a Dr goes against guidelines

A

Clear documentation of the reasoning behind the decision should be made

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

How can you discharge your duty of care

A

Seek advice the assistance from more senior colleagues
Make a note of advice in the medical records: date, time, who spoke to and the agreed plan
The responsibility then falls on the more senior colleague

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

The ‘but for’ test

A

To establish causation the claimant must answer “but for the Defendant’s negligence would the harm have occurred to the claimant in any event?”
Balance of probabilities is also used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Examples of causation - negligence

A

Histopathology - Cancer metastasis, reduced life expectancy.

A&E - non-union led to fixation surgery, decreased ROM

62
Q

Good Samaritan Act

A

When a doctor, who is not on duty, helps in emergency situation
A doctor has no legal obligation to treat someone who is not his patient

63
Q

Vicarious liability

A

In respect of the acts and omissions of all their staff committed in the course of their employment
If the healthcare professional negligently performs his duty of care to the patient the NHS is liable

64
Q

NHS indemnity

A

NHS indemnity introduced in 1990

All NHS hosp indemnified their own staff against legal liability

65
Q

When did all NHS trusts get covered under the CNST

A

Since 31 March 1995, all NHS Trusts have been covered under the Clinical Negligence Scheme for Trusts (CNST)

66
Q

Unforgettable medical scandals in the UK

A 
Western Sussex Hosp – listeria outbreak 
Drug -resistant superbugs 
Whorlton hall abuse 
Stafford Hosp scandal (Mid Staffs)
Bristol Royal Infirmary heart scandals 
Alder Hey Hosp organ scandal 
Infected blood scandal
67
Q

Whorlton Hall abuse

A

Patients w/ learning disabilities and autism

68
Q

BRI scandal

A

170 children died due to hosp keeping hearts; Kennedy Enquiry

69
Q

Alder Hey Hosp organ scandal

A

Retained organs and foetuses; Redfern Enquiry

70
Q

Infected blood scandal

A

Haemophilia patients given blood infected w/ HIV and Hep B/C

71
Q

Donaldson Report

A

Prof Liam Donaldson, Chief Medical Officer
At least 105,000 organs retained at hosp and med schools across England
Adequate and free consent was rarely obtained

72
Q

Following the organ retention scandal

A

Retained Organs Commission (ROC) established in April 2001 until 31 March 2004
Legislation: Human Tissue Act 2004 and Coroners Amendments Rules 2005
Litigation - Claimants BRI as a group shared £3.6 million and had legal costs paid of £1.7 million. Memorial plaque erected at Alder Hey.

73
Q

Impact off medical scandals

A 
Patient safety – a high priority 
Goal is harm-free patient care 
Openness/ Transparency/ Accountability 
Protecting whistleblowers 
GMC – Revalidation every 5 years 
Duty of Candour 
Changes to Coroner rules
74
Q

GMC revalidation

A

Licensed doctors have to revalidate, every 5 years, by having regular appraisals that are based on GMC core guidance – Good Medical Practice (2013)

75
Q

Whistleblowing

A

Employee speaks out about wrongdoings in the healthcare setting in the public interest

76
Q

Legal framework protecting whistleblowers

A

Employment Rights Act, 1996
Public Interest Disclosure Act, 1998
Equality Act 2010
The Enterprise and Regulatory Reform Act, 2013

77
Q

Candour

A

“The volunteering of all relevant information to persons who have or may have been harmed by the provision of services, whether or not the information has been requested and whether or not a complaint or a report about that provision has been made.”

78
Q

When was contractual Duty of Candour put in place

A

2013

79
Q

When did Duty of Candour become statutory

A

2014

80
Q

Notifiable pt safety incidents

A

Any incidents which does or could cause death; severe; moderate or prolonged psychological harm

81
Q

Examples of moderate harm

A

Unexplained return to surgery
Unplanned readmission
Extra time in hospital
Cancelling treatment

82
Q

Examples of severe harm

A

Permanent lessening of bodily sensory, motor or intellectual function e.g. removal or wrong limb/ organ

83
Q

What is classified as prolonged harm

A

For at least 28 days

84
Q

Notifiable pt safety incidents

A

Any incidents which does or could cause death; severe; moderate or prolonged psychological harm

85
Q

Examples of moderate harm

A

Unexplained return to surgery
Unplanned readmission
Extra time in hospital
Cancelling treatment

86
Q

Examples of severe harm

A

Permanent lessening of bodily sensory, motor or intellectual function e.g. removal or wrong limb/ organ

87
Q

What is classified as prolonged harm

A

For at least 28 days

88
Q

Live birth

A

A foetus, whatever its gestational age, exits maternal body and subsequently shows any signs of life (voluntary movement

89
Q

Miscarriage

A

Spontaneous loss of a pregnancy before 24 weeks gestation

90
Q

Legal status of foetus

A

Foetus does not acquire any legal rights until it can survive independently from its mother

91
Q

Congenital Disability (Civil Disability) ACT 1976

A

Gives rights to a child born handicapped to sue in negligence in limited circumstances – mother exempted

92
Q

HRA 1998 - Article 2

A

Everyone’s right to life shall be protected by law (does not apply to foetus – Vo v France)

93
Q

HRA 1998 - Article 3

A

Prohibition of torture (prolonging life)

94
Q

HRA 1998 - Article 8

A

Right to private & family life

95
Q

HRA 1998 - Article 12

A

Men and women of marriageable age have the right to marry and found a family

96
Q

Time period to register a birth

A

42 days

97
Q

Registering a birth when parents are married

A

At time of conception or birth, either the mother or father can register the birth on their own

98
Q

Registering a birth if parents are unmarried

A

Details of both will be on certificate if they sign birth register together, a statutory declaration of percentage is prepared or a court order indicating parental responsibility is taken. Fathers’ details do not have to be included

99
Q

Registering a birth - married same sex couples

A

Either can register if the child born by donor insemination or fertility treatment

100
Q

Regisyerig a birth - same sex couples (unmarried)

A

Must get a parental order – cannot get this until 6 weeks after birth
Therefore, birthmother must register

101
Q

What is parental responsibility

A

Defined in the Children Act 1989 “all the rights, duties, powers, responsibilities and authorities which by law a parent of a child has in relation to the child and his property”

102
Q

How can an unmarried father obtain parental responsibility

A

Marrying the mother
Having his name registered
Making a parental responsibility agreement with the mother
Obtaining a parental responsibility order fork the court
Obtaining a residence order from the court
Becoming the child’s guardian on the mother’s death

103
Q

When do adoptive parents get parental responsibility

A

On adoption

104
Q

How do step parents obtain PR

A

By obtaining a parental responsibility order form the court

105
Q

Do foster parents have PR

A

No, it either remains with the parents or is shared between the parents and local Authority

106
Q

Do sperm donors have PR

A

If donation through HFEA licensed clinic, not the legal parent of child (no financial obligation, no rights, not on birth certificate)
If unlicensed clinic, will be legal father of the child

107
Q

Do egg donors have PR

A

If you give birth, you are the legal mother, even with a donated egg

108
Q

Surrogacy Arrangement Act 1985

A

“Surrogate mother” – a woman who carries a child in pursuance of an arrangement:

a. Made before she began to carry the child and
b. Made with a view to any child carried in pursuance of being handed over to, and [PR being met} by another person(s)

109
Q

Are surrogacy agreements legally enforceable

A

No, even if a contract has been signed and expenses of the surrogate has been paid

110
Q

Surrogacy and PR

A

The surrogate is legal mother unless or until parenthood is transferred to the intended parents (either by parental order or adoption)
Husband of surrogate also has PR
Surrogate has the legal right to keep the child, even if it is not genetically related to her

111
Q

Applying for a parental order

A

You must be genetically related to a child to apply for a parental order =, i.e., the egg/sperm donor, and in a relationship where you and your partner are either married/ civil partners/ living as partners
You and your partner must also:
- Have the child living with you
- Reside permanently in either the UK, Channel Islands, or isle of Man

112
Q

When must a parental order application be made

A

When the child is under 6 months

113
Q

Adoption following surrogacy

A

If neither you or your partner are related to the child, or you’re single, adoption is the only way you can became the child’s legal parent
Subject to Adoptions Act 1976

114
Q

Brainstem death

A

The irreversible cessation of the integrative function of the brainstem equates with death. and allows the medical practitioner to dx death

115
Q

Purpose of medical certfcation of death

A

Enables the family to register the death
Provides an explanation of how/ why pt. died
Informs research into health effects of exposure to a wide range of risk factors

116
Q

Who should certify a death

A

Statutory duty of Dr who attended in the last illness to complete
In a team of Drs – lead Consultant has the ultimate responsibility for this
If you cannot fulfil the above, must refer the death to HM Coroner

117
Q

What does it mean to attend to a pt - death certificate

A

Dr who cared for pt. during illness that led to death
Must be familiar with PMH, ix and treatment
Seen the pt. in last 14 days, seen the body after death

118
Q

Role of Medical Examiner

A

All deaths will be subject to either a ME scrutiny or a Coroner’s ix
Agree proposed cause of death and accuracy of MCCD with Dr
Discuss COD with NOK and establish if they have any q’s or concerns with care before death
Inform local morality arrangements

119
Q

What to avoid when writing cause of death

A

Avoid ‘old age’ alone
Never use ‘natural causes’ alone
Avoid terminal events, mode of dying and other vague terms i.e., terms that do not identify disease e.g., cardiovascular event

120
Q

Two ways to have a post-mortem

A

Coroner orders it to try and determine cod or
Agreed upon by the hosp and the family to gain fuller understanding of the deceased’s illness or cod and/or to enhance future medical care

121
Q

What needs to be observed during a post-mortem

A

HTA 2004 and Code of Practice in either case

122
Q

Coroner’s post-mortem

A

Doesn’t require consent of family
Must be done by a suitable practitioner – as soon as reasonably possible
Must comply with HTA 2004 standards
The Coroner must release the body for burial/cremation as soon as practicable usually with 28 days
If PM confirms natural cod; coroner doesn’t need to hold inquest

123
Q

Laws on burial

A

No law that a body has to be buried in an authorised place e.g., graveyard
Not illegal to bury a body in your back garden as long as you obtain consent from the local authority; keep a burial register and it is not going to poison water supply

124
Q

The cremation (England and Wales) Regulations 2008

A

The cremation (England and Wales) Regulations 2008
Cremation 4 – usually dr who has seen deceased in last illness
Cremation 5 – confirmatory certificate – nor mainly being done by the Medical Examiner. Speak to Crem 4 drs
Medical referee at crematoria

125
Q

Notifications of death regulations 2019

A

In force 1 October 2019
Now a duty to report certain categories of deaths to the Coroner
Must inform Coroner as soon as reasonably practicable
May need to inform police if death through to be suspicious

126
Q

What is an unnatural death

A

Need a suspicion of foul play or other wrongdoing e.g., incl medical treatment for non-fatal conditions which leads to death or respiratory disease (asbestosis) because of employment
Violent death involves an injury of some sort e.g. deliberate killing, accident e.g., cut, fall or RTA, struck by lightening

127
Q

Purpose of Coroner’s inquest

A

Identify who the decreased was
How, when and where the deceased came by his/her death
Is a fact-finding hearing

128
Q

Inquest hearing

A

Public heating, media can be present
Relatives can attend, ask q’s, be legally represented
Trust’s solicitor or barrister will be there if staff requested to provide written statement/ give oral evidence

129
Q

What determination must a coroner reach during an inquest

A 
Name of deceased 
The. Medical cause of death 
How, when and where the D’cd came by their death 
The conclusion (verdict)
Registration particulars
130
Q

Possible outcomes of an inquest (verdict)

A

Natural causes – incl fatal medical condns
Accident/ misadventure
Industrial disease of ..
Dependence on drugs/ issue of drugs
Killed himself
Killed unlawfully
Open verdict insufficient evidence – case left open
Neglect
Narrative verdicts – brief description of factual events
Can only be challenged by judicial review

131
Q

Adverse findings of an inquest - neglect

A

Gross failure to provide basic care
Does not look at clinical judgement
Must be over a period of time

132
Q

Adverse findings of an inquest - Regulation 28 report

A

Repost on action to prevent future deaths
Coroner now has a duty to issue a report to public authorities’ circumstances which pose a risk of future deaths
A copy of the report is sent to the Chief Coroner who publishes them

133
Q

Donoghue v Stevenson

A

Mrs D had a ginger beer in a café and the bottle was found to have a decomposing snail inside
Developed gastroenteritis and brought a claim against manufacture
No ‘contractual’ relationship bust she successfully argued a claim in the tort of negligence as manufacturer owed the consumers a duty of care

134
Q

The cost of making mistakes

A

The annual cost of harm arising from clinical actives during 2019/20 covered by the Clinical Negligence Scheme for Trusts was £8.3 billion, reducing from £8.8 billion for 2018/2019” - NHSR

135
Q

The standard of proof required in a negligence claim

A

Balance of probabilities” – more likely than not e.g., 51%

136
Q

Hatcher v Black [1954]

A

Pt suffered s/e from an operation on their throat and sued the surgeon

137
Q

Bolam Test

A

A mentally ill pt. was given ECT during which P suffered a fractured pelvis and other injuries. Risk could’ve been reduced if relaxant drugs was given but medical professionals were divided on the matter

138
Q

Bolitho

A

The Bolam test was reviewed and confirmed by the House of Lords in Bolitho
The views of the expert must be honestly and sincerely held
The Courts, not the medical profession, are the final arbiters of the standard of care in clinical negligence claims
Bolam is still good law, but Dr must still be able to show that this opinion has a logical basis

139
Q

What is the Standard of Care that has to be attained

A

Not that of the highest skilled practitioner but that of the ordinary competent practitioner in that field
Standards are those which were adopted at the time of the negligence, not at the time of the trial.

140
Q

Wilsher v Essex AHA [1986]

A

The argument that a junior doctor did their best in view of their inexperience, was rejected.
The law requires all medical staff to meet the standard of competence

141
Q

What happens if negligence is proved

A

Compensation known as “damages” is awarded

No special rules applied to damages awarded in clinical negligence cases

142
Q

Aim of damages

A

To put the claimant in the same position as they would’ve been if there was no negligence

143
Q

How many times are damages awarded

A

Once

144
Q

Provisional damages

A

Provides the pt. with the option to return to court to seek a further sum of compensation if they deteriorate significantly after orig claim is settled

145
Q

What prevents just anyone from seeking damages

A

Costs – Loser pays winner’s costs

146
Q

What are general damages awarded for

A

“Pain, suffering and loss of amenity”

Based on JSB guidelines and case law

147
Q

What are special damages

A

Quantifiable losses e.g., past, and future loss of earning, cost of nursing care, aids, and equipment and other out of pocket expenses

148
Q

Good Samaritan Acts - contractual duty

A

“You must offer help if emergencies arise in clinical setting or in the community, taking account of your own safety, your competence and the availability of ither options for care” – Good Medical Practice – para 26

149
Q

What should be considered when offering help - GSA

A

Your safety
Your competence
The availability of other options

150
Q

Social Action, Responsibility and Heroism Act 2015

A

You should:
Make a detailed record of the incident and your involvement
Obtain consent from the pt.
Explain your actions and treatment to the patient

151
Q

CNST

A

Run by NHS Resolution (NSHR)
Created a pooling arrangement to meet liabilities arising out of pt. claims
“Premiums” for individual Trusts are worked out, depending on the type of Trust, specialities offered, scale of operations and standards achieved

MBBS - Year 1 (93 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions