Medical Law and Ethics

Question 1

What is the concept of confidentialityin clinical practice? Why is it important?

Answer 1

1. Part of patient autonomy and privacy rights.
2. Essential for building trust relationships.
3. Supported by ethical principles like beneficence and non-maleficence.
4. Legally enforced through common and statute law.
5. Necessary for maintaining professional integrity and patient care quality.

Question 2

Explain the legal reasons why someone could breach confidentiality.
What should you consider when breaching confidentiality?

Answer 2

1. Required by law (e.g., notifiable diseases).
2. Ordered by a judge (court orders).
3. Public interest (preventing harm).
4. Under specific statutory provisions (e.g., DVLA, terrorism).
5. Balancing the right to privacy with the need to protect society.

Question 3

Describe the ethical considerations in informing a patient of a terminal diagnosis.

Answer 3

1. Respecting patient autonomy by providing full information. 2. Avoiding harm through careful communication. 3. Balancing beneficence and non-maleficence. 4. Considering the patient’s capacity to understand and cope. 5. Involving family members with the patient’s consent.

Question 4

What are the challenges in maintaining confidentiality in modern healthcare settings?

Answer 4

1. Technological challenges (e.g., electronic records, social media). 2. Physical spaces (e.g., open wards, shared offices). 3. Professional boundaries and team communication. 4. Legal requirements for information sharing. 5. Balancing patient privacy with the need for clinical information.

Question 5

Discuss the concept of ‘best interests’ in paediatric care.

Answer 5

1. Consideration of the child’s physical and emotional needs.
2. Assessing the child’s wishes and feelings.
3. Evaluating the potential benefits and harms of treatment.
4. Involving parents and family in decision-making.
5. Using legal frameworks (e.g., Children Act 1989) to guide decisions.

Question 6

What are the Fraser Guidelines in the context of adolescent contraception?

Answer 6

1. The minor understands the advice.
2. The doctor cannot persuade the minor to inform parents.
3. The minor is likely to continue having intercourse.
4. The minor’s physical or mental health will suffer without treatment.
5. It is in the minor’s best interest to provide advice or treatment without parental consent.

Question 7

Explain the concept of Gillick competence.

Answer 7

1. Assessment of a minor’s capacity to consent. 2. Based on maturity and understanding, not age alone. 3. Allows minors under 16 to consent to medical treatment. 4. Requires understanding of treatment benefits and risks. 5. Recognized in UK law following the Gillick case.

Question 8

Describe the legal and ethical significance of the Mental Capacity Act 2005.

Answer 8

1. Provides a framework for assessing capacity. 2. Defines incapacity and sets out principles for decision-making. 3. Promotes autonomy and protects vulnerable individuals. 4. Ensures decisions are made in the best interests of those lacking capacity. 5. Emphasizes the importance of supporting individuals to make their own decisions.

Question 9

What are the main points of the Children Act 1989 regarding child welfare?

Answer 9

1. Emphasis on the child’s welfare as the paramount consideration. 2. Consideration of the child’s wishes and feelings. 3. Assessment of the child’s physical and emotional needs. 4. Importance of family life and maintaining relationships. 5. Legal framework for parental responsibility and court orders.

Question 10

Discuss the ethical dilemmas in end-of-life care for the elderly.

Answer 10

1. Balancing autonomy and best interests. 2. Managing pain and suffering (beneficence vs. non-maleficence). 3. Deciding on the use of life-sustaining treatments. 4. Involving family members in decision-making. 5. Addressing issues of dignity and quality of life.

Question 11

What are the ethical considerations in adolescent refusal of treatment?

Answer 11

1. Assessing the minor’s capacity and competence. 2. Balancing respect for autonomy with best interests. 3. Considering the severity and urgency of the medical condition. 4. Involving parents and seeking their views. 5. Legal framework for overriding refusal if necessary (e.g., life-saving treatment).

Question 12

Explain the role of the GMC in regulating medical practice.

Answer 12

1. Maintaining registers of qualified doctors. 2. Promoting good medical practice. 3. Ensuring high standards of medical education and training. 4. Addressing issues of fitness to practise. 5. Providing ethical guidance to medical professionals.

Question 13

Describe the legal distinction between civil and criminal law.

Answer 13

1. Civil law deals with rights and duties between individuals. 2. Criminal law addresses offences against the community. 3. Civil cases initiated by claimants; criminal cases by the state. 4. Civil law focuses on compensation; criminal law on punishment. 5. Different standards of proof: balance of probabilities vs. beyond reasonable doubt.

Question 14

What is the ‘Four Principles’ approach to medical ethics?

Answer 14

1. Autonomy: respecting patient’s decision-making rights. 2. Beneficence: promoting the patient’s well-being. 3. Non-maleficence: avoiding harm to the patient. 4. Justice: ensuring fairness in medical decisions. 5. Provides a balanced framework for ethical analysis.

Question 15

Explain the concept of ‘virtuous behaviour’ in medical ethics.

Answer 15

1. Focus on the character and virtues of the healthcare provider. 2. Traits like compassion, honesty, and integrity. 3. Emphasis on moral excellence and professional conduct. 4. Encourages continuous moral development. 5. Complements principle-based and consequentialist approaches.

Question 16

Discuss the ethical considerations in resource allocation in healthcare.

Answer 16

1. Ensuring fair distribution of limited resources. 2. Prioritizing treatments based on effectiveness and need. 3. Balancing individual needs with population health. 4. Addressing inequalities and promoting equity. 5. Involving stakeholders in decision-making processes.

Question 17

What are the key ethical issues in palliative care?

Answer 17

1. Managing pain and symptoms to enhance quality of life. 2. Respecting patient autonomy and wishes. 3. Balancing life-prolonging treatments with comfort care. 4. Involving family in care decisions and support. 5. Addressing psychological, social, and spiritual needs.

Question 18

Describe the concept of ‘informed consent’ in medical practice.

Answer 18

1. Providing patients with sufficient information about treatment. 2. Ensuring understanding of benefits, risks, and alternatives. 3. Obtaining voluntary agreement to proceed with treatment. 4. Respecting patient autonomy and decision-making capacity. 5. Continuous process requiring clear communication.

Question 19

Explain the significance of the case Gillick v West Norfolk and Wisbech AHA.

Answer 19

1. Established the concept of Gillick competence for minors. 2. Recognized minors’ ability to consent based on maturity. 3. Influenced subsequent legal and ethical guidelines. 4. Highlighted the balance between parental rights and minor autonomy. 5. Set a precedent for assessing competence in healthcare.

Question 20

What are the main points of the Family Law Reform Act 1969 regarding minors?

Answer 20

1. Allows minors aged 16-18 to consent to medical treatment. 2. Consent is treated as if given by an adult. 3. Does not apply to refusal of treatment. 4. Recognizes the capacity of minors to make informed decisions. 5. Provides legal clarity on consent for adolescents.

Question 21

Discuss the ethical implications of managing non-adherent adolescents in healthcare.

Answer 21

1. Respecting autonomy while ensuring adherence to treatment. 2. Addressing underlying reasons for non-adherence. 3. Balancing paternalism with respect for individual choice. 4. Involving family and support systems in care plans. 5. Legal and ethical considerations in enforcing adherence.

Question 22

What are the ethical issues in disclosing genetic information to family members?

Answer 22

1. Balancing patient confidentiality with family risk. 2. Respecting patient autonomy and wishes. 3. Considering the potential harm to family members. 4. Legal obligations and professional guidelines. 5. Communicating risks and benefits effectively.

Question 23

Explain the ethical and legal considerations in paediatric organ donation.

Answer 23

1. Parental consent and child’s best interests. 2. Assessing the potential benefits and risks of donation. 3. Legal requirements and guidelines for consent. 4. Ethical principles of beneficence and non-maleficence. 5. Addressing emotional and psychological impacts on families.

Question 24

What are the main points of the Mental Capacity Act 2005?

Answer 24

1. Framework for assessing capacity in adults. 2. Principles to support individuals in making decisions. 3. Best interests decision-making for those lacking capacity. 4. Protection for healthcare providers acting in good faith. 5. Emphasis on least restrictive options and promoting autonomy.

Question 25

Discuss the ethical challenges in managing sexually active minors.

Answer 25

1. Assessing Gillick competence and confidentiality. 2. Legal age of consent and reporting requirements. 3. Balancing confidentiality with child protection. 4. Providing appropriate sexual health education and services. 5. Involving parents and legal guardians when necessary.

Question 26

Explain the role of courts in authorizing medical treatment for children.

Answer 26

1. Courts can overrule parents and children in best interests. 2. Use of specific issue and prohibited steps orders. 3. Applying the inherent jurisdiction of the court. 4. Ensuring treatment decisions comply with legal standards. 5. Balancing parental rights and child welfare.

Question 27

What are the key ethical principles in adolescent mental health care?

Answer 27

1. Respecting autonomy and involving adolescents in decisions. 2. Ensuring confidentiality while considering safety. 3. Balancing beneficence and non-maleficence in treatment. 4. Addressing stigma and promoting mental well-being. 5. Involving family and support systems appropriately.

Question 28

Describe the ethical issues in withdrawing life-sustaining treatment.

Answer 28

1. Assessing the patient’s wishes and advance directives. 2. Balancing beneficence and non-maleficence. 3. Involving family in decision-making processes. 4. Legal requirements and guidelines for end-of-life care. 5. Ensuring compassionate and respectful communication.

Question 29

Discuss the ethical considerations in reporting communicable diseases.

Answer 29

1. Balancing patient confidentiality with public health needs. 2. Legal requirements for reporting certain diseases. 3. Informing patients about reporting obligations. 4. Ethical principles of beneficence and non-maleficence. 5. Ensuring timely and accurate communication to authorities.

Question 30

Explain the ethical principles in conducting paediatric research.

Answer 30

1. Ensuring informed consent from parents and assent from children. 2. Balancing potential benefits and risks to child participants. 3. Ensuring confidentiality and privacy of data. 4. Adhering to ethical guidelines and regulatory requirements. 5. Involving ethics committees in the approval process.

Question 31

What are the main ethical issues in adolescent reproductive health care?

Answer 31

1. Assessing competence and confidentiality (Gillick competence). 2. Providing appropriate sexual health education and services. 3. Balancing parental involvement with adolescent autonomy. 4. Addressing consent and refusal of treatment. 5. Legal and ethical guidelines for managing reproductive health.

Question 32

Describe the ethical implications of handling cases of domestic abuse in healthcare.

Answer 32

1. Ensuring patient safety and confidentiality. 2. Legal requirements for reporting and intervention. 3. Providing appropriate support and resources. 4. Balancing autonomy with protection and intervention. 5. Ethical principles of beneficence and non-maleficence.

Question 33

Explain the concept of ‘duty of care’ in medical practice.

Answer 33

1. Legal obligation to provide a standard of care. 2. Ensuring patient safety and well-being. 3. Adhering to professional guidelines and standards. 4. Accountability for actions and decisions in patient care. 5. Ethical principles of beneficence and non-maleficence.

Question 34

What are the ethical issues in managing confidential information of deceased patients?

Answer 34

1. Confidentiality obligations continue after death. 2. Legal access to health records under the Access to Health Records Act 1990. 3. Balancing family requests with confidentiality. 4. Ethical principles of respecting patient wishes. 5. Professional guidelines for handling post-mortem information.

Question 35

Discuss the ethical considerations in managing patient information in the digital age.

Answer 35

1. Ensuring data privacy and security (e.g., electronic records). 2. Addressing risks of unauthorized access and breaches. 3. Balancing transparency with confidentiality. 4. Legal requirements under data protection laws (e.g., GDPR). 5. Ethical principles of trust and professional responsibility.

Question 36

What are the main points of the Human Rights Act 1998 relevant to healthcare?

Answer 36

1. Right to respect for private and family life (Article 8). 2. Right to life (Article 2). 3. Right to freedom from torture and inhumane treatment (Article 3). 4. Right to a fair trial (Article 6). 5. Balancing these rights with public health needs.

Question 37

Explain the ethical principles in the GMC guidelines for doctors.

Answer 37

1. Respect for patient autonomy and dignity. 2. Commitment to beneficence and non-maleficence. 3. Ensuring justice and fairness in patient care. 4. Maintaining confidentiality and trust. 5. Continuous professional development and competence.

Question 38

What is the ethical basis of consent in medical practice?

Answer 38

1. Respects patient autonomy and their right to self-determination. 2. Builds trust between patient and healthcare provider. 3. Promotes beneficence by aligning treatment with patient preferences. 4. Upholds respect for persons and their dignity. 5. Legal and professional requirement for ethical medical practice.

Question 39

Describe the elements required for valid consent.

Answer 39

1. Competence: Patient must have the ability to understand and decide. 2. Information: Adequate information about the nature and purpose of the procedure, including risks and benefits. 3. Voluntariness: Consent must be given freely without coercion. 4. Understanding: Patient must understand the information provided. 5. Ongoing process: Consent can be withdrawn at any time.

Question 40

Explain the legal implications of invalid consent.

Answer 40

1. Battery: Touching a patient without valid consent can lead to a charge of battery. 2. Negligence: Providing inadequate information can result in negligence claims. 3. Assault: When a patient anticipates being touched without valid consent. 4. Legal consequences include civil or criminal charges against the healthcare provider. 5. Valid consent requires the patient to understand the nature and purpose of the treatment.

Question 41

What is the Montgomery ruling regarding consent?

Answer 41

1. Duty to ensure patients are aware of material risks and alternatives. 2. A risk is material if a reasonable person in the patient’s position would likely attach significance to it. 3. Doctors must consider what patients would deem significant, not just what is professionally standard. 4. Emphasizes patient-centred care and informed decision-making. 5. Changed the legal landscape, requiring more comprehensive information disclosure.

Question 42

Discuss the professional basis for obtaining consent according to GMC guidelines.

Answer 42

1. Patients have the right to be involved in decisions about their treatment. 2. Decision-making is an ongoing process of meaningful dialogue. 3. Patients must be given the information and time they need to make informed decisions. 4. Doctors must presume all adult patients have capacity unless proven otherwise. 5. Consent must be obtained from patients or those legally able to consent on their behalf.