Medical Law Flashcards
What is the definition of confidentiality?
The state of keeping or being kept secret or private
What are some of the details of the Hippocratic oath?
- Solidarity with teachers and other physicians
- Beneficence and non-maleficence towards patients
- Not to assist in suicide or abortion
- To leave surgery to surgeons
- Not to harm, especially to not seduce patients
- To maintain confidentiality and never to gossip
What are the four domains in Good Medical Practice?
- Knowledge, skills and performance
- Safety and quality
- Communication, partnership and teamwork
- Maintaining trust (Includes confidentiality!)
In what situations may confidentiality of the dead be broken (aside from to appropriate authorities, next of kin)
Medical Certificate Cause of Death
How does the GDPR define personal data?
Any information relating to an identified or identifiable natural person (‘data subject’)
What are the six data protection principles of the GDPR?
Personal data must-
- Be processed lawfully, fairly and in a transparent manner
- Be processed for specified, explicit and legitimate purposes and not in any manner incompatible with those purposes
- Be adequate, relevant and limited to what is necessary in relation to the purposes
- Be accurate and up to date
- Must not be kept for longer than is necessary
- Be secure
What are the principles in which personal data guidance is underpinned in good medical practice?
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
List some situations in which confidentiality can be breached
- With the patient’s consent
- With other medical practitioners in the patient’s interest
- In the doctors own defence
- Statutory requirements – prevention, detection and prosecution of serious crime
- When directed to by a court of law
- Protection of other persons
- In the public interest (terrorism, murder, culpable homicide, rape)
- Child abuse
What regulates the GMC?
Professional Standards Authority
What is the statutory responsibility of the GMC?
- Produce the Medical Register - its membership
- Responsible for overseeing and certifying the appropriateness of medical education
- Fitness to practice
For what reason may a patient make a complaint?
- Error
- Grief
- Poor understanding/poor explanation
- Unrealistic expectations
- Failure to appreciate needs/wishes of patient
What does the GMC say about complaints?
- You have a professional responsibility to deal with complaints constructively and honestly.
- Have to cooperate with any complaints procedure
- Must not allow a patient’s complaint to prejudice the care or treatment you provide for that patient
- When appropriate you should offer an apology
What may disciplinary procedures of employers relate to?
- Terms and conditions of service
- Appraisal
- Job planning
- Time keeping
- Absence
Where may cases sent to the GMC be heard?
Medical Practitioners Tribunal Service (MPTS)
What may GMC cases include?
- Manner and atitude
- Dishonesty
- Sexual impropriety
- Criminal convictions
- Health issues - drink driving/abuse of drugs/mental health
- Significant Performance issues
What types of criminal allegations can be made against doctors?
Indecent assault Prescription fraud Manslaughter Murder Deception offences
What is the definition of civil law?
Concerned with the rights and property of individual people or organisations, which may not always be protected by criminal laws.
List some examples of civil law cases?
- Family disputes
- Personal injury cases (eg medical negligence)
- Breach of contract/promise
- Employment law
What is the definition of criminal law?
Relates to offences and breaches that negatively affect society as a whole, rather than one person
What is the definition of medical negligence?
-A lack of reasonable care and skill as a result of which the patient suffers
What must be demonstrated to fulfil the legal definition of medical negligence?
- Is there a legal duty to provide care and skill (a contract)?
- Failure of ‘reasonable care and skill’ - error that no competent person in that field would make
- Actual damage must have occurred as a direct result
List some examples of losses that may lead to compensation in medical negligence cases?
- Loss of earnings
- Expenses incurred
- Impaired enjoyment of life
- Permanent incapacity
- Procreative incapacity
- Pain and suffering indured
- Death
What are potential lines of defence in medical negligence claims?
- Deny the charge
- True facts but not the pursued doctor’s fault
- Patient took a risk - consented procedure
- Contributory Negligence (Claimant’s negligence contributed)
What are strategies for avoiding/minimalizing risk of complaints of negligence?
Join a medical defence organisation
Be aware of and follow the GMC’s Advice, “Good Medical Practice”
Seek advice early
Be aware of the local complaints procedure / deal with complaints expeditiously
Maintain good records
Delegation
Comments about colleagues
Courtesy and hostility
Report early to Defence Organisation
List some of the ‘duties of a doctor’ as said by the GMC?
- Make the care of your patient your first concern
- Treat every patient politely and considerately
- Respect patients’ dignity and privacy
- Listen to patients and respect their views
- Give patients information in a way they can understand
- Respect the rights of patients to be fully involved in decisions about their care etc
What is consent?
Giving permission before receiving treatment, test or examination.
Must be done on basis of explanation with experienced clinician.
In what situations would written consent be needed?
Procedures that involve higher risk eg surgical intervention
What could examination/treatment without appropriate consent be considered?
Common assault/Indecent assault
What else is explicitly needed in the case of intimate examinations?
A chaperone
What should the patient be informed of in informed consent?
- Practicalities of procedure
- Benefits/risks of procedure
- Benefits/risks if procedure not done/refusal of treatment
What should be recorded regarding patient decisions in their medical records/consent form?
- Information discussed
- Specific requests by the patient
- Written/visual/audio information given to the patient
- Details of decisions made
What may be an obstacle affect capacity?
Impaired intellectual/mental capacity
Unconsciousness
Communication difficulties
Age
Temporarily…
- Pain
- Fear
- Confusion
- Effects of medications/drugs/alcohol
What powers are granted by Power of Attorney?
Allows an individual (with capacity) to grant someone they trust with powers to act as financial/welfare attorney should they lose capacity.
What can be used to obtain consent in the case of communication difficulties?
- Next of kin
- Braille information leaflets/consent form
- Sign language
- Interpreter via telephone/person
Over what age are people entitled to consent to their treatment in Scotland?
16
What is Gilick competence?
If a child under 16 is believed to have enough intelligence, competence and understanding, they can consent to their own treatment without parental consent.
What are Fraser guidelines?
-Gilick competence specifically applied in the case of contraceptive advice
When may consent be overruled in the young person?
-If a young person refuses treatment which may leas to their death or severe permanent injury - may go through Court of Protection