PAL Block 1

Question 1

4 pillars of medical ethics

Answer 1

Beneficence, nonmaleficence, Justice, Patient autonomy

Question 2

4 sources of medical ethics

Answer 2

Geneva Declaration, WMA international code of medical ethics, AMA code of ethics, AMC GPGs

Question 3

4 sources of human rights

Answer 3

UDHR, ICCPR article 7, UN CROC, ACT Human Rights Act (2004)

Question 4

General sources of health law

Answer 4

AHPRA national law especially 3.2(a), constitution s51 xxiiia (no conscription clause), ACT Civil wrongs act 2002 s42 (negligence), case law

Question 5

Avoid expression of personal beliefs

Answer 5

“AMC 8.2.3, my beliefs remain with me”

Question 6

Wellbeing of child 1st priority

Answer 6

“AMC 3.6.1: those 3 and 6 are number 1”

Question 7

Consider child’s capacity for decision making

Answer 7

“AMC 3.6.2, maybe this child is as smart as you” and “Gillick competency”

Question 8

AHPRA immediate action and right to respond

Answer 8

“AHPRA law 156, you’re in trouble quick sticks” and AHPRA 157

Question 9

Public protection and safety by suitably trained and ethical doctors

Answer 9

AHPRA national law 3.2 (a)

Question 10

Avoid abuse of power for exploitation

Answer 10

1. AMC GPGs 3.2.6 and “8.2.2 - don’t abuse those close to you”

Question 11

3 requirements for negligence to have occurred

Answer 11

1. A duty of care, 2. A breach of that care, 3. causally related damage

Question 12

Patient would have had procedure even if they knew the material risks

Answer 12

Rosenberg Case or Wallace vs Kam (would have proceeded in the face of generalised risks but not specific subjective risks)

Question 13

Scope of consent exceeded and actionable trespass committed

Answer 13

Reeves v R (Butcher of Bega)

Question 14

Informed consent of material risks

Answer 14

Rogers vs Whittaker

Question 15

Patient would have proceeded anyway despite material risk

Answer 15

Rosenberg v Percival and Wallace v Kam

Question 16

Breaches of confidentiality due to imminent harm

Answer 16

Tarasoff case

Question 17

Mandatory reporting sexual abuse

Answer 17

Children and young people act 2008 s356

Question 18

4 mandatory breaches of confidentiality

Answer 18

1. suspected child abuse: children and young people act 2008 s356; 2. suspicion of impaired colleague: AHPRA national law; 3. notifiable diseases: public health act 1997; 4. mental health concerns and firearm ownership: Firearms act 1996

Question 19

Concept of reasonable duty of care to patient relating to negligence

Answer 19

civil wrongs act 2002(ACT) s42

Question 20

Case regarding the best definition of reasonable standard of care and not “the best doctor”

Answer 20

“Chappel vs Hart, only the best man for the part”

Question 21

Ensure best practice to minimise risks

Answer 21

AMC GPGs 6.1 and “6.2.6, we should minimise the risks”

Question 22

Patient’s right to complain

Answer 22

AMC GPGs 3.11.1

Question 23

Law relating to negligence

Answer 23

ACT Civil Wrongs Act 2005 “failure to exercise reasonable care and skill”

Question 24

An apology is not an admission of liability

Answer 24

Civil Wrongs Act 2.3 14a

Question 25

Example of failed standard of care

Answer 25

Naxakis case where contrast CT not performed and boy died

Question 26

Loophole cases through which abortion is legal

Answer 26

R vs Wald and R vs Davidson

Question 27

Parents can consent for their child only for therapeutic treatments, elective treatments require court order

Answer 27

Marion's Case Australian High Court

Question 28

Cases outlining when a baby is considered alive

Answer 28

R vs Hutty further interpreted in R vs Iby (heartbeat alone is enough)

Question 29

Advanced directive to refuse treatment

Answer 29

Medical Treatment Act 2006 "section 7, I want to go to heaven"

Question 30

Doctors protected from liability if following an advanced directive

Answer 30

Medical Treatment Act 2006 s16

Question 31

Cases dictating that withholding futile treatment is not the same as physician assisted dying

Answer 31

Bland's Case (UK), Schiavo case (USA), Messiha Case (ACT)

Question 32

Victorian law prohibiting addition of PAD in an advanced directive

Answer 32

Victorian Assisted dying legislation (2017) "clause 138, you're not allowed to book your fate"

Question 33

Requirements in victorian assisted dying legislation 2017

Answer 33

mental illness or disability alone are not sufficient

Question 34

Ethical guide for end of life care

Answer 34

NSW dying with dignity guidelines, AMA euthanasia guidelines, doctrine of double effect

Question 35

Ethics of Confidentiality

Answer 35

AMC 3.2.3 & 3.4

Question 36

Ownership of medical records

Answer 36

Breen v Williams - patients do not automatically own records

Question 37

Human Rights of confidentiality

Answer 37

UDHR Article 9 "Privacy and Confidentiality" and Article 10 "Equality, Justice, Equity"

Question 38

Human Rights link to Gillick competence

Answer 38

UN CROC Article 12: "article twelve for a 12 year old"