My notes Block 11 Flashcards
What are some objections to IVF?
Involves destruction of embryos
Harmful to those trying to conceive
It is unnatural
What are some arguments for IVF?
Welfare interests
Procreative autonomy
What does the human fertilisation and embryology act 1990 say? And what was updated in 2008?
A woman shall not be provided with treatment unless account has been taken of the welfare of any child that may be born of that treatment, including the need for a father.
Updated in 2008 to say need for supportive parenting rather than the need for a father
What does the abortion act 1967 state?
Abortion is legal if 2 medical practitioners are of the opinion, formed in good faith that:
pregnancy has not exceeded its 24th week and continuing with pregnancy is greater risk than ending it
Termination is necessary to prevent permanent injury to physical or mental health of women
Continuing with pregnancy risks woman life more than if terminated
That there is substantial risk that baby would be seriously handicapped
What is the harm principle?
The only purpose for which power can be rightfully exercised over any member of a civilised community against their will is to prevent harm to others
What is stated in the Fraser guidelines regarding children and sexual health?
You can provide contraception, abortion and STI advice and treatment to a child under 16 without parental consent providing that-
They understand the advice and their implications
You can’t persuade them to tell their parents
In relation to contraception you can give it of they are gonna have sex with or without it
That their physical health will suffer without treatment
That you are acting in their best interest
How can oxytocin be stimulated naturally?
Pressure on cervix Vaginal fullness Pelvic floor pressure Crowning Oxytocin positive feedback loop- more stretch get more release- Ferguson reflex
How do interventions decrease natural production of oxytocin?
Anaesethic injections inhibit Ferguson reflex
Inductions flood receptor sites so they are less sensitive to natural oxytocin
Episiotomy- reduces oxytocin as there is less stretching of the perineum
When is the highest child mortality?
Infancy- linked to congenital defects and preterm births
What is the leading cause of child death after infancy?
Injury- especially in male adolescents, suicide also a leading cause of death in adolescence
What are some next steps to reduce childhood mortality?
Reduce risk of preterm birth
Promote maternal health
Improve recognition and management of serious illnesses
Improve management of long term conditions like cystic fibrosis and asthma
Improve policies on common causes of death like accidents
Help improve poverty and education
What is the SHMI 2018- summary hospital level mortality indicator?
Compared actual mortality rates within 30 days of discharge to expected numbers given certain characteristics, then hospitals were categorised by whether they had more of less expected deaths.
What does the care quality commission do?
Regulates quality of all health and social care providers
Licenses providers of health and social care
CQC inspects different GP/ hospitals and grades it
What are some healthcare regulators?
Department of health and NHS England Health protection agency GMC Revalidation of doctors Royal Colleges
What is an adverse event?
An unintended event resulting from clinical care and causing patient harm
