Patient Values and Narratives

Question 1

What is a patient’s narrative and it’s clinical application?

Answer 1

• a patient’s narrative is the kind of patient that individual is, their story and the meaning behind it
• it needs to be heard to reduce diagnostic/therapeutic errors, and for the patient to feel understood and cared for

Question 2

What are the 4 attributes of care that must be maintained?

Answer 2

• must act in accordance with relevant legislation
• must not treat patients unfairly
• must not deny patients access to appropriate services or care
• must not cause patients distress

Question 3

What is conscientious objection?

Answer 3

the choice to opt out of providing a particular procedure because of personal beliefs and values and long as it does not discrimminate against or harrass individual/groups of patients.

You must not refuse to treat patients/groups of patients because of personal beliefs or views about them. And must not refuse to threat the health consequences of lifestyles choices you object because of personal beliefs

Question 4

How does the BMA support conscientious objection?

Answer 4

• emphasise balance between doctors’ freedom and the right of the patient to receive appropriate care
• a treating doctor’s primary obligation is to their patient
• support CO in 3 cases: abortion, fertility treatment and withdrawal of life-sustaining treatment

Question 5

Describe the Janaway case?

Answer 5

• Barabara Janaway was a receptionist who refused to type a referral letter for an abortion
• was fired on grounds of misconduct
• she believed she had statutory protection over her conscientious objection to the abortion and took action against her firing
• the court dismissed it as the task was an obligation of her employment and had no direct involvement with the abortion
• she sought an appeal which was again dismissed