open Flashcards
What is an audit
is a process where systematically looking at procedure used for diagnosis, care and treatment, how the associated resources are used and investigating the effect care has on the outcome and quality of life for the patient, AUDIT is mainly for continuous monitor and to remedy deficiencies
Advanced medical directive:
a legal document for person indicated that they do not wish to receive extraordinary life sustaining treatment in event of terminal illness, where death is inevitable and impending
Legal doc fill with MO, under Advanced medial directive act
what is Advanced care planning
Advanced care planning is a process for person, family, and healthcare staff to discuss care preferences for the future when the person can no longer express their wishes
It is a medical document kept in a case note and healthcare computer system
Activates when the pt loses mental capacity
How to access soundness of mind
Incapable of knowing the nature of the act. (The nature of the act refers to situations where the accused was not able to understand his actions.)
Incapable of knowing what he is doing is wrong. (The act must be considered “wrong” by ordinary standards of reasonable and honest persons, or in the sense that the act breaks some law.)
Completely deprived of the power to control his actions. (This refers to situations where the accused may not have satisfied either of the two conditions above, but is unable to stop himself from performing the act because he is suffering from a certain mental disorder.)
Testing fitness to plead
Pritchard criteria :
- understanding the charges and deciding whether to plead guilty or not
- following the course of the proceedings
- challenge a juror
- instructing counsel
- Giving evidence to their own defense
What is therapeutic boundaries and boundaries violation
Therapeutic boundaries refer to the margins of appropriate behaviour by the therapist. If a boundary is “violated”, it implies that the practi- tioner has transgressed; that is, they have acted in a way which fails to reach the moral standards required within the therapeutic relationship.
scales for ADLS
BADLs: basic
Barthel Index for Activities of Daily Living
Instrumental Activities of Daily Living Scale
What is MTO and wad is its criteria
sentencing option that allows the courts to order an offender to undergo compulsory psychiatric treatment in lieu of imprisonment for a 3 year period
Offenders with recognisable and treatable psychiatric illness
Psychiatric illness which is a contributing factor to the offending behaviour
18-62yo; first time offenders (mostly); minor offences only
Must be willing to undergo monthly psychiatric appointments for up to 3 year period
Willing to be compliant to prescribed treatment in any form
Be prepared to be contacted/home-visited regularly by clinical staff
Adequate family/social support (preferred)
Financial standing of offender and his ability to pay all or part of treatment costs
Note that for MTO the following inclusion/exclusion criteria apply:
Inclusion: mood, anxiety, psychotic disorders; limited impulse control disorders on case-by-case basis
Exclusion: personality disorders, substance/addictive disorders, mental retardation, IED, certain offences under CPC
Principles of MCA
Principles:
A person must be assumed to have capacity unless it is established that the person lacks capacity.
A person is not to be treated as unable to make a decision unless all practicable steps to help the person to do so have been taken without success.
A person is not to be treated as unable to make a decision merely because the person makes an unwise decision.
An act done/a decision made under this act for or on behalf of a person who lacks capacity must be done/made in the person’s best interests.
Before the act is done/decision is made, regard must be had to whether the purpose for which it is needed can be effectively achieved in a way that is least restrictive of the person’s rights and freedom of action.
LPA what is and what are the types
Lasting Power of Attorney (LPA)
A legal document under which the donor confers on the donee (or donees) authority to make decisions about all of any of the following, when the donor no longer has the capacity to make such decisions:
Personal welfare or specified matters concerning one’s personal welfare
Property and affairs or specified matters concerning one’s property and affairs
The instrument may appoint them to act:
Jointly: donees have to act together and cannot act separately
Jointly and severally: donees can take the decision together or separately. Both types of decisions are valid.
Jointly in respect of some matters and jointly/severally in respect of others
What is court appointed deputy
person appointed by the court to make certain decisions on behalf of a person who lacks mental capacity when the person has not made an LPA and has no donee to decide on his behalf in respect of those decisions.
MHCTA
MHCTA
-section 7, duty of police offer to apprehend any persons believed to be dangerous to himself/herself or other persons and such danger is reasonably suspected to be attributable to mental disorder, and take the person together with a report of facts of the case without delay to –
Any medical practitioner for an examination and the medical practitioner may thereafter act in accordance with section 9; or
Any designated medical practitioner at a psychiatric institution and the DMP may thereafter act in accordance with section 10
Sec 9: Where a medical practitioner has under his or her care a person believed to be mentally disordered or to require psychiatric treatment, the medical practitioner may send the person to a designated medical practitioner at a psychiatric institution for treatment and that designated medical practitioner may thereafter act in accordance with section 10’‘Sec
10: A DMP at a psychiatric institution who has examined any person who is suffering from a mental disorder and is of the opinion that that person should be treated, or continue to be treated, as an inpatient at the psychiatric institution may at any time sign an order in accordance with Form 1 in the Schedule —
(a) for the admission of the person into the psychiatric institution for treatment; or
(b) in the case of an inpatient, for the detention and further treatment of the person
A person must not be detained at a psychiatric institution for treatment unless —
(a) the person is suffering from a mental disorder which warrants the detention of the person in a psychiatric institution for treatment; and
(b) it is necessary in the interests of the health or safety of the person or for the protection of other persons that the person should be so detained.
Children and young persons act
what is it
What is its principles
What is the power
Children and young persons act
A key legislation that safeguards the care, protection and rehabilitation of our children and young persons.
Principles
- The parents or guardian of a child or young person are primarily responsible for the care and welfare of the child or young person and they should discharge their responsibilities to promote the welfare of the child or young person; and
- In all matters relating to the administration or application of this Act, the welfare and best interests of the child or young person must be the first and paramount consideration.’
Protection of children and young persons
Power to obtain/communicate information
Power to order child/young person to be produced for assessment or treatment
Power to remove child/young person to place of temporary care and protection
Enhanced powers for guardians of vulnerable children:
Enhanced Care and Protection Order (ECPO): allows MSF and designated caregivers to make decisions, just as what parents would do in normal family settings
Support to youth offenders:
Allow youth offenders to declare that they do not have a criminal record if they successfully complete Youth Court orders
Protect youth offenders’ identities for life, unless they reoffend
Guide families in parenting, with community support:
Family Guidance Orders (FGO)
Require parents, with their child, to complete a family programme to address parent-child conflicts
Allow parents to apply to court for an FGO if the child is <16yo
Sex with minor how to proceed
age wise what is legal
Sex with Minors
Legal age for sex in SG: 16yo
Under CPC, persons under the age of 16 are unable to give consent to any sexual activity
Therefore, it is illegal and a punishable offence to have sex with a person (whether vaginal, oral or anal) under the age of 16, whether or not the minor says yes to the act, under Section 376A of the Penal Code
Section 377D of the Penal Code states that being mistaken about your partner’s age is not a valid defence for any sexual offence charges.
Sexual intercourse <14yo constitutes statutory rape, even with consent
Between 14-16yo: sex with minor (if no consent 🡪 rape, as per usual)
Penetrative sexual activity with minors aged 16-18 within exploitative relationships is also illegal under CPC
Consider age of minor, age gap between parties, nature of parties’ relationship, extent of control or influence that the accused exercised over the minor
what is the definition of
vulnerable adult
abuse
neglect
Self neglect
Vulnerable Adult:
(a) is 18 years of age or older; and
(b) is, by reason of mental or physical infirmity, disability or incapacity, incapable of protecting himself or herself from abuse, neglect or self‑neglect;
Abuse: physical, emotional or psychological abuse (ie no financial component); conduct/behaviour by an individual that in any other way controls/dominates another individual and causes the other individual to fear his safety/wellbeing
Neglect: lack of provision to the individual of essential care (such as but not limited to food, clothing, medical aid, lodging and other necessities of life), to the extent of causing or being reasonably likely to cause personal injury or physical pain to, or injury to the mental or physical health of, the individual
Self-neglect: failure of the individual to perform essential tasks of daily living (such as but not limited to eating, dressing and seeking medical aid) to care for himself or herself, resulting in the individual —
(a) living in grossly unsanitary or hazardous conditions;
(b) suffering from malnutrition or dehydration; or
(c) suffering from an untreated physical or mental illness or injury
