Medical Law Flashcards
1
Q
Describe the 4 purpose law
A
- To establish and define standards of acceptable
- To maintain standards and punish’ ‘offences’
- To protect the vulnerable
- To achieve the resolution of disputes
2
Q
Describe the 3 types of law
A
- Criminal law - seeks to punish for a defence
- Civil law - seeks to achieve a remedy
- Public law
3
Q
What are the two sources of law
A
- Statue
- Common Law/Case Law
4
Q
Give examples of statue law
A
- Abortion Act 1967
- Human Tissue Act 2004
- Human Fertilisation & Embryology Act 1990
- Human Rights Act 1998 - Mental Capacity Act (MCA) 2005
5
Q
Describe 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 the future cases
6
Q
List the regulations and professional guidance in medicine
A
- EU directive
- GMC -licensing of doctors
- Regulatory bodies
7
Q
Define ‘breach of duty’
A
Failing to act in accordance with the standards of reasonably competent medical men acting in the relevant field at the relevant time
8
Q
In terms of clinical negligence what are the 4 things the claimant (patient) must establish within the limitation period (3 years)?
A
- That they were owed a duty of care
- That the duty of care was ‘breached’
- That they have sustained an injury (loss)
- Injury was ‘caused’ by that breach of duty (causation)
9
Q
What is required for a person to refuse life saving treatment?
A
- 18+ and mentally competent
- Must be in writing
- Be signed and witnessed
- Must be clear what treatment is being refused and under what circumstance
- State clearly that the decision applies, even if life is at risk
10
Q
Desrcibe the legal duties of confidentiality
A
- Common law and statute
- Human Rights Act 1998 - artcile 8, GDPR and Data Protection Act 2008
11
Q
Decsribe the professional duties of confidentiality
A
- E.g. the GMC
- Confidentiality is central to trust between doctors and patients
- Without assurances about confidentality, patients may be relcutant to seek medical attention or to give docotor the information they need to provide good care
- Appropriate information sharing is essential to the efficient provision of safe, effective care for the patient and wider community
- Duty of confidentiality is included within NHS employment contracts
- Manadatory training staff required to complete
12
Q
a) Describe role of GDPR AND DPA 2018
b) Who is responsibe for holding these rights?
b) Who does it not apply to?
A
a) Regulates the processing and personal of personal data about living individuals
A health record is considered ‘personal data’
All personal data must be processed ‘fairly and lawfully’
b) Information Commissioner’s Office (ICO) responsible for upholding these rights
c) Deceased patients or where the information is adequately anonoymised
13
Q
Describe technology problems causing confidentiality issues
A
- Misdirect emails where 2 people have similar names
- Email forwrding
- Information lost, left somewhere or stole e.g. unencyrpted memory sticks, ward/team hand over notes
14
Q
Describe casual conversation problems cauing confidentiality issues
A
- Many improper disclosures are unintentional
- Patients in the public eye
15
Q
Describe social medial probelms causing confidentiality issues
A
- GMC Doctor’ use of social media (2013)
- Facebook/twitter
- Peer group fourms
16
Q
Describe the conequences of a breach in confidentiality
A
- Serious peristent failure to follow GMC guidance puts your registrayion at risk
- Criminal prosecution
- Dismissal
- Embarrassment and bad publicity for employer
- Financial penalty for your employer
17
Q
Describe the 2-stage test of capacity (MCA 2005)
A
- Does the person have an impairment of their mind or brain, whether beacuse of an illness, or external factors e.g., alcohol or drugs use?
- Does the impairment mean the person is unable to make a speicifc decision when they need to?
18
Q
Describe the features of a valid consent
A
Voluntary
- Patient must be free to agree/refuse treatment
- Conset should be obtained without coercion or duress
Informed
- The procedure/treatment must be explained in simple language
- Complictins/risks/side-efefcts should be discussed
- Any research on the condition should be discussed
Capacity
- Must understand the relevant information provided
- Be able to retain the information
- Be able to weigh up the pros and cons of the treatment proposed
- Be able to communicate their decisions
19
Q
Provide situations where treatnent is given without consent
A
- Emergency situation to save life, patient incapacitated. May be unconscious
- Requires another medical procedure during an operation, waiting would be detrimental to patient
- Severe mental health and lack capacity to consent e.g., dementia, schizophrenia, bipolar disorders
- Severe mental health, attempted suicide, or self-harm whilst competent but refusing treatment
- Risk to public health e.g., TB, rabies, cholera
- Severely ill and living in unhygienic conditions - patient can be taken to a place a care without their consent
20
Q
What must you do when a person regains capacity after a treatment when they had no capacity was given
A
- Explain what has been done so far
- Discuss the options for onging managment in line with standard guidance
21
Q
Define confidentiality
A
The principle of keeping information given by or about an individual secure sand secret from others during a professional relationship
22
Q
Describe ‘Gillick’ competent child
A
Rights of the child to have confidential advice and treatment more than any right of the parent
23
Q
What are the consequences of no confidentiality when children are patients
A
- Children might not seek medical care
- Might not tell the necessary facts
24
Q
a) What are young people ages 16-17 presumed competent entiled to?
b) What if they are not competent?
A
a) Entitled to the same duty of confidence as adults
Have same rights as adults over their personal data
b) Consent by someone with parental responsibilty if they are acting in the best intrests of the child (if not, the medical team can apply for a court order)
25
a) What are the rights of children with capacity in regards to their own health records
b) In what cases can parents access child's record
c) Does divorce or seperation affect parental responsibility
a) They have the legal right to access their records
They can allow or prevent access by others, inlcuding their parents
b) If the child consents
If the child lacks capacity and it is in the child's best interest
c) No
26
Describe the sliding scale of competance
The younger you are, the harder to demonstrate you have ability to make descicions yourelf
Preserve - right to consent treatment but do not deny
27
What are under 16's who aren't Gillick competent owed?
* Owed duty of confidentiality on first impression
28
a) What are adult who lack capacity owed?
b) What does sd(7) of the mental capacity act 2005 state about the people involved in their care
a) Owed duty of confidentiality
b) States that people who are involved in their care should be consulted about their wishes any relevant values and wishes
29
a) Describe confidentiality in regards to deceased patients
b) Provide examples of when relevant information is disclosed in deceased patients
c)
a) Generlly considered that duty of confidentiality survives death
Any request by the patient for their information to remain confidential after death should be respected
b) To assit a coroner
Court order/required by law
Access to health records act 1990 - permits access to records of decaease patient by thise with a claim arising out of the patient's death
30
In what cases can you breach confidentiality?
1. Conset of patient (implied or expressed)
2. In the patient's best intrests
3. Required by law (statue and judge-ordered)
4. For the protection of patients and others -'public interest'
31
Discuss disclosure when patient gives consent
* Patients must understand and agree what is to be disclosed, reason for disclosure and consequence
* Any disclosure should be kept minimum
* Implied conset: family members, to disclose to other members of the healthcare team
* Balancing excercise -continuityof care means that other healthcare professionak need access to information about a patient
* A wish expressed not to disclose information to other healthcare professionals must be respected
32
Discuss disclosures in the best interest of patients
* Emergency situations e.g. information may be requested from a patient's GP by A&E staff - 'act of necessity' in patent's best interest
* Only disclose relevant information
* When disclosure is in medical interests of someone incapable of giving consent
33
Discuss when disclosures by the law is required
* Legislistaion provides for the obligatory disclosure of information under circumstances e.g. Public health (control of disease)
* NHS counter fraud investigations
* GMC - investigation of a doctor's fitness to practice
* You must give information required by a court of law, coroner, child protection proceedings
* If you have to breach confidence as a court witness, this is "privelaged" - It is for the judge to ensure that the confidence is only breached to the extent necessary for trial
34
Discuss when disclosures due to public interest is required
* To prevent and support detection, investigation and punishment of seious crime
* Where they judge that the public benefits outweighs the obligations of confidentiality
* Reporting concerns about patients to the DVLA - April 2017
* Reporting gunshot and knife wounds - April 2017
* Disclosing information about serious communicable diseaes - April 2017
35
Discuss when disclosures to protect the patient are required
* Adults who may be risk of harm - approach depends on whether the patient has capacity or not
* Protecting children and young people: the resposibilties of all doctors came into effect 3 September 2013
36
Discuss when disclosures to the police are required
Disclosures are required in:
* serous crimes and national security e.g. muder, rape, treason, kidnapping or serious harm the surety of the state/public order, crimes involving substancial financial gain
* Order from a circuit judge required to obtain records of a victim of crime or suspesting (if no consent) or a special procedure warrant if they are investigating a 'serious arrestable offence'
Disclosures not required in:
* Theft, fraud or damage to property where loss and damage is not substancial generally do not warrant a breach of confidence
37
Discuss how knife/gunshot wounds should be reported
The police should be informed quickly whenever a person arrives with a gunshot wound/injury from attack with a kinfe/blade/sharp insttrument
A professional judgement about whether disclosure of personal information about a pateint, inclduing their identity, is justified in the public interest
38
Describe the role of the police when they attend to a knife/gunshot wound at the hospital
* Usually come to the hospital as soon as possible
* Their job is to assess risk of further attack, risk to staff patients and visitors
* Police will usually want to see the patient but treatment and care of patient comes first
* A patient may refuse tospeak to polcie and a healthcare professional must abide by that
39
What are the caldicott principles?
Rules and regulations that guide a patient's confidentiality
40
What must all staff who have access to personal infomation do in regards to the caldicott principles?
Handle personal information as defined by Caldicott principles
41
What is right of rectification?
Individuals have the right to correct inaccurate or incomplete data
42
a) What is right of erasure?
b) What's the exception of this? and why
a) Allows individuals to request removal or deletion of personal data e.g. Where the data is no longer necessary for the purpose it was collected
b) Health records because it will allow people to refuse to comply with request of personal data if necessary
43
What is negligence?
Neglience is any act or omission which falls short of the standard to be expected or "the reasonable man"
44
Which speciality/specialities has the highest number of clinical negligence claims?
Orthopaedic surgery and obstretics
45
What 4 things must the claimant/patient establish for negligence to be established
1. That they were owed a _duty of care_
2. The duty of care was _breached_
3. They have sustained an injury
4. Which was _caused_ by that breach of duty
46
What is the Bolam test?
The Bolam test is a test that is judged by the medical professional's peers. They must be able to show that any medical professional who was in the same position as them would have done the same, giving the same outcome.
47
To successfully defend a clinical negligence claim using the bolam test, the doctor needs to call evidence that shows two things. What are these two things?
1. A reasonable body of doctors
2. Who are skilled in that particular speciality and would've done just the same as the defendant doctor did
48
The Bolam test is applied to all aspects of the doctor/patient relationship with an exception of one type of case. What is this exception?
With the exception of consent cases
49
What is a 'responsible' body?
A small number of specialists constitutes as a responsible body
50
In a negligence case, what happens if the expert evidence/professional opinion does not withstand logical analysis by the judge?
If in a rare case, it can be demonstrated that the professional opinion is not capable of withstanding logic analysis, the judge is entitled to hold that the body of opinion is not reasonable or responsible..." -Bothilo
51
Who are the final arbiters of the standard of care in clinical negligence claims?
The court
52
Increasingly judges are considering guidelines (NICE, GMC, Royal Colleges) in determining the appropriate standard. What must a doctor do if they depart from the guidance?
Clear documentation of the reasoning behing the decisions should be made
53
Describe the standard of care that has be attained
The standard of care that has to be attained is not that of the highest skilled practitioner but that of the ordinary competent practitioner in that field.
54
Discuss whether inexperience is defence for negligence
* Inexperiecne is no defence, all doctors are judged by the same standards
* The law requires all medical staff to meet the standard of competance and experience society expects from those working in such a unit
* In Wilsher vs Essex AHA, the argument that a junior doctor did their best in view of their inexperience, was rejected. Court of Appeal decided that the trainee or learner is to be judged by the same standards as his more experience colleagues
* An inexperienced doctor should ask for expert assistance if the task is beyond his ablity
55
Describe how you can discharge duty of care
* Seek evidence and assistance from more seniour colleagues
* Make a note of advice in the medical recors: date, time, who you spoke to, and the agreed plan
* The respnsibility then falls on the more senior colleagues
56
To establish causation the claimant must answer one question. What is this question?
"But for the defendant's negligence would the harm have ocurred to the claimant in any event?". This is known as the "but for" test
57
* Court decided there had been a breach of duty on the part of the doctor for failing to examine the men.
* BUT even if he had examined and treated Mr Barnett, the probability was that he would have died in any event
* The widow’s claim failed. On what grounds did the widow's claim fail?
The widow's claim failed on causation
58
Describe material contribution aspect of a negligence claim
Patient does not have to show error was the sole or main cause of damage, provided the error materially contributed to damage
59
What does the claimant recieve if negligence is proved?
Compensation known as "damages" is awarded - no special rules applied to damages awarded in clinical negligence cases
60
Descrime the main elemens of a "damage" awarded as compensation
* Aim - to put the claimant in the same position as they would've been if there was no negligence
* Damages awarded only once
* Provisional damages - provides the patient with the option to return to courtto seek a further sum of compensation if they deteriorate significantly after original claim is settled
* Have 3 years from date to discovery to bring claim
61
'Damages' are broken down into general damages and special damages. Explain what these terms mean
General damages
* Awarded for "pain, suffering and loss of amenity"
* Based on JSB guidlines and case law
Special damages
* Quantifiable losses e.g., past, and future loss of earning, cost of nursery care, aids, and equipment, and other out of pocket expenses
62
Discuss the legal and professional position concering "Good Samaritan" acts
* The good samirtans act is when a doctor, who isn't on duty, helps in an emergency situation
* A doctor has no legalobligation to treat someone who is not not their patient
* GMC states "You must offer help if emergencies arise in clinical setting or in the community, taking account of your own safety, your competance and the availability of either options for care"
63
Discuss what you should consider when offering help in an emergency situation, when you're off duty
* Your safety - do not put yourself at unnecssary risk
* Your competence - don't try to work outside your abilities, or whilst under the influence
* The availability of other options - are more qualified or able people on the scene?
* Where possible: make a detailed record of the incident and your involvement, obtain conset and explain your actions and treatment to the patient
64
Explain vicarious liability of the NHS
* CCG's and NHS trust hospitals owe a vicarious duty of care to patients
* In respect of the acts and omissions of all their staff committed in the course of their employment
* If the healthcare professional negligently prforms his duty of care to the patient, the NHS is liable
65
What is NHS indemnity?
All NHS hospitals indemified (compensate for harm or loss) their owen staff aganst legal liability
66
Outline 8 key NHS scandals in the UK
1. Western Sussex Hospital - Listeria outbreak
2. Cooked and frozen food served in hospitals
3. Drug-resistant superbugs
4. Whorlton hall abuse - patients with learing disabilities and autism (undercover footage)
5. Stafford hospital scandal (Mid Staffs) - Operation and general care investigated as high mortalilty rates were reported
6. Briston Royal Infirmary heart scandals - 170 children died due to hospital keeping hearts
7. Alder Hey hospital organ scandal - retained organs and foetuses
8. Infected blood scandal - Haemophilia patients give blood infected with HIV and Hep C
67
How did the "culture"of organ retention come about?
* Doctors felt that telling parents exactly what happened during and after a post-mortem examination was too distressing
* Parents did not realise that by signing a conset form for a post-mortem stating "tissues may be reatined" that they were allowng the hospitals to remove and dispose of all their child's organs
68
Describe what the Donaldson report found in terms of organ retention
* At least 105,000 organs retained at hospital and medical schools across England
* Adequate and free conset was rarely obtained
69
Exlain the impact the organ retention scandals had on improving patient safety in the NHS
* Retained Organs Commission (ROC) established in April 2001 until 31 March 2004
* Legistlations - Human Tissue Act 2004 and Coroners Amendments Rules 2005
* Changes to coroner rules
* Protecting whistleblowers
* GMC - revalidation every 5 years
* Duty of candour
70
Describe the role and fundamental principle of the Human tissue act 2004
* Role - regulates all aspects of human transplantation, whether organs (or tissue) are removed from the living or dead
* Fundamental principles - all donations, including cadaver donations, must be based on 'appropriate consent' (explicit consent for cadaver donation)
71
What is 'whistleblowing'
An employee or former employee raises concern about wrong doings in the public interest
72
Discuss the legal frameworks and policies that protect whistleblowers
* Employment Rights Act - whistle-blowers protected from being subjected to any detriment or dismall because they have made a protected disclosure
* Public Interest Disclosure Act, 1998 - to protect whistle-blowers from detrimental treatment who disclose information 'in the public interest'
* Equality Act 2010
* The Enterprise and Regulatory Reform Act, 2013 - safeguards whistle-blowers and protects employers from spurious claims and rules out 'gagging orders'
* Nationwide pilot to help NHS whistleblowers back into work launched by NHS England – August 2017
73
Describe the role of GMC and whistleblowing
From 1st April 2017 GMC is legally obliged to publish ananoymised annual report on the actiontaken as a result of whistleblowing disclosures
74
Describe the support for juniors doctors in whistleblowing
In August 2016 Health Education England (HEE) introduced whistleblowing protection for junior doctors - it provides a new legal route to allow trainees to makelegal claims if they believed it had caused detriment to their career
75
Describe the role of the GMC
* Protect patients
* Set standards for education and training for medical students and doctors
* Maintain the medical register (regulation and licencing)
* Revalidation of docotors
* Ethical guidance
* Investigate concerns
76
In the GMC guidance, what are doctors advised to do if they believe that the patient safety or care is being compromised by the practice or colleagues or the systems, policies, and procedures in the organisations in which they work?
* Doctors have a duty to raise concern
* Doctors should keep a record of their concern and the actions taken to resolve them
77
Dsicuss the medical practitioner tribunal service (MPTS)
* The tribunals decide if a doctor's fitness to practice medicine is impaired and what action, if any, is needed
* The GMC can bring a case agaisnt a docotr following an investigation into a concern raised to them
* Hearings are public, except, where they are considering confidential information, or information about doctor's health
78
Explain the meaning and aim of of revalidation for doctors
Licensed doctors have to revalidate, every 5 years, by having regular appraisals that are based on GMC core guidlnines
These revalidations gives patients confidence that doctors are up to date with training,drives improvement in clinical governance and improves quality of care of patients
79
Discuss the term 'duty of candour' and what this means for doctors in practice
* Contractual duty of candour in place since 2013 and statutory from 2014
* It is the volunterring of all relevant information to persons who have or may have been harmed by provision of services, whether or not the information has been requested and whether or not a complaint or a report about provision has been made
* Contractural - the patient or their family/carere must be informed that a suspected or actual patient safety incident has occurred within at most 10 workind days of the incident being reported (related to patient safet incident that result in modeate harm, severe harm or death)
* Statutory - All health and social care providers registered with CQC subject to a statutory duty of candour
80
What is a notifiable patient safety incident?
Any incidents which does or could cause death; severe; moderate or prolonged psychologial harm
81
Describe the steps to meet the duty of candour
82
Descrie the key elements of supporting a patient or their family when things have gone wrong
* Promptly acknowledging the incident
* Taking the patient's and family's concerns seriously
* Responding with compassion and understanding
* Providing an explanation which is truthful, timely and clear
* Avoiding medical jargon in explanation
* Providing a sincere and meaningful apology
* Designating a single point of contact for the patient or family
* Treating patients and their families with respect and consideration
83
Describe the role of the Healthcare Safety Investigation Branch and The Healthcare Service Safety Investigation Body (HSSIB)
* Conducts independant investigations of patient safety concerns in NHS-funded care across England
* Two programmes: national investigations (up to 30 per year), maternity investigations
* It will be a crimincal offence to fail without reasonable excuse to answer questions/provide information to HSSIB as requested
84
Describe the NHS complaints procedure
Level 1 - Local resolution
* Involve the person whom the complaint was made responding either or in person to the complainant
* Hospital Trusts provide a lay counciliator to facilitate such meetings
Level 2 - Independant review
* A complaintant who is not satisfied by attempts at local resolution can request an independant review of the complaintant
* All Trusts will have a complaints convenor who will decide whether to set up an independant review panel or retun the complaint to the local level
* The function of the panel is to investigate the complaint and make a report setting out its conclusions, with appropriate comments and suggestions.
* The report is sent to the Chief Executive of the Trust, who must then write to the complainant informing them of any action that is being taken as a result of the panel's deliberations and the right of the complainant to take their grievance to the ombudsman
Level 3 - Ombudsman
* The ombudsman is a civil servant, independant of the NHS, who is responsible for reporting to parliament about the running of the NHS
* It is up to the ombudsman whether or not to further investigate any complaints
85
# Define:
a) Live birth
b) Full term birth
c) Preterm birth
d) Miscarriage
e) Still birth
a) A foetus, whatever its gestational age, exits maternal body and subsequently showns any signs of life
b) Born between 38-42 completed weeks gestation
c) Preterm birth - born alive before 37 completed weeks of pregnanacy
d) Micarriage - spontaneous loss of pregnancy before 24 weeks gestation
e) Stillbirth - born after 24 weeks of pregnancy and did not at any time after being expelled from its mother, breathe, or show any signs of life
86
Describe the legal status of a foetus in english law and under the human rights act
* Foetus does not acquire any legal rights until it can survivie independently from its mother
87
When must a birth be registered in England and Wales
A birth must be registered within 42 days (6 weeks)
88
If parents are married (or in civil partnership) at time of conception or birth. WWho must register the birth of the baby?
Either the mother or father can register the birth on their own
89
How do unmarried parents register a birth of a baby?
Details of both will be on certificate if they sign birth register together, a statutory decleration of percentage is prepared or a court order indicating parental responsibility is taken. Fathers' details do not have to be included
90
Describe how same-sex female couples can register a birth of a baby
* Married/civil partners - either can register if the child is born by donar insemination or fertility treatment
* Unmarried - partner can be together on birth certificate if they are treated together in the UK by a licensed clinic and made a parenthood agreement
91
Describe how same-sex male couples can register a birth of a baby
* Must get a parental order - cannot get this until 6 weeks after birth therefore, birth mother must register
92
How can unmarried fathers gain parental responsibility?
* Marrying the mother
* Having his name registered
* Making a parental responsibility agreement with the mother
* Obtaining a parental responsibility order from the court
* Obtaining a residence order from the court
* Becoming the child's guardian on the mother's death
93
When do adoptive parents require parental responsibility?
An adoptive parent will require parental responsibility on adoption
94
How can step-parents gain parent responsibilty
They can be obtaining a parental responsibilty order from the court
95
Who has the parental responsibility in foster parents?
Foster parents do not have parental responsibility,, it either remains with the parents or is shared between the parents and local authority
96
Who has the parental responsibility in spern and egg donors?
Sperm donors
* If donation though HFEA (human fertilisation and embryology act) 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
Egg donors
* If you give birth, you are the legal mother, even with a donated egg
97
Who has parental reponsibility in surrogacy?
* 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 parental responsibility
* Surrogate has the legal right to keep the child, even if it is not genetically related to her
98
a) You must be genetically related to a child to apply for a parental order, and in a relationship where you and your partner are either married/ civil partners/ living as partners. What other conditions must also be followed?
b) If neither you or your partner are related to the child, or you’re single, what is the only way you can became the child’s legal parent?
a)
* You and your partner must have the child living with you and reside permanently in either the UK, Channel Islands, or Isle of Man
* Application must be made when child is under 6 months olds
b) Adoption - subject to adoptions act 1976
99
Describe the role of the medical examiner
* Agree proposed causes of death and accuracy of MCCD with doctor
* Discuss proposed cause of death with next oof kin and establish if they have any questions or concerns with care before death
* Inform local morality arrangements
100
Who should certify a death?
* Statutory duty of doctor who attended in the last illness to complete - a doctor who acred for patient during illness that ledto death, must be familiar with PMH, investigations and treatment + seen the patient in the last 14 days or seen the body after death
* If this cannot be fulfilled then it must be referred to the death of HM coroner
101
Describe the purpose of a medical certificate ccause of death (MCCD)
* Enables the family to register the death
* Provides an explanation of how/why patient died
* Informs research into health efefcts of exposure to a wide range of risk factors
102
What must you avoid writing as a cause of death on the medical certificate cause of death (MCCD)
* 'Old age'
* 'Natural causes'
* 'Organ failure
* Terminal events, mode of dying and other vague statements e.g., terms that do not identify disease e.g., cardiovascular event
103
Describe the legal proceedings of cremation
* Aides the vremation (England and Wales) regulations 2008
* Need two certificates: cremation 4 - usually doctors who has seen deceased in last illnes and cremation 5 - Confirmatory certificate
* Medical referee at crematoria
104
When does the coroner get involved?
* Identity of person unkown
* No attending doctor able to complete MCCD (or unavailabe within a reasonable time)
* Violence, trauma, or injury
* Self-harm
* Neglect (including self-neglect)
* Undergoing treatment or procedure of a medial or similar nature
* Injury or disease attributable to any employment held during lifetime
* Death in custody or othwerwise in state detention
* Death may be suicide
* Use of mecidinal product, use of controlled drug or psychoactive substance
* Unnatural but does not fall within any other category
105
a) What are the possible outcomes (verdicts) a coroner can come to?
b) Who can challenge this?
a)
* Natural causes – include fatal medical conditions
* Accident/ misadventure
* Industrial disease of ...
* Dependence on drugs/ issue of drugs
* Suicide
* Killed unlawfully
* Open verdict insufficient evidence – case left open
* Neglect
* Narrative verdicts – brief description of factual events
b) Can only be challenged by judicial review
106
What is the regulation 28 report?
Coroner now has a duty to issue a report to public authorites' circumstances which pose a risk of future deaths - a copy of the report is sent to the chief coroner who publishes them
