PPVE Flashcards by Kieran Chalmers

Prima facie

Fidelity
Justice
Beneficence
Non-maleficence
Self-improvement

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GMC 4 Domains of Good Med Practice

Knowledge/skills
Comms/teamwork
Safety and quality
Maintaining trust

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Absolute duties examples

Do not lie
Do not kill innocents
Respect otherw

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Absolute duties def

MORAL OBLIGATIONS which must always be fulfilled

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Prima facie def

Moral obligations that are binding but may be overridden by pressing duties

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Deontology

Follow rules

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Utilitarianism/consequentialism

Focuses on result of an action

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4 quadrant approach

Medical indications
Patient preferences
QOL
Contextual features

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Valid consent

Informed
Pt has capacity
Voluntary
Ongoing

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Acts that allow access to med records

Data protection act
Freedom of info
Access to medical records act

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Data protection act 1998

Legal responsibility to keep med records confidential
Sharing is permissible for med purposes
Data anonymous unless consent given

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Freedom of information act

NHS must provide info to public about itself and respond appropriately to requests of info

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Access to medical records act

Allows individual to access medical records for employment or insurance purposes

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Access to health records 1990

Provides some individuals with a statutory right to access medical records of deceased

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Caldecott guardian

Person responsible for protecting confidentiality and ensuring proper storage of info

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Formal curriculum

Intended, offered and endorsed by institution

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Hidden curriculum

Unintended learning experiences within medical education

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+ves for having access to Pts as learning resource

Entitled
Central to med education
Helps students engage in their own healthcare

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-ves to having access to Pts as learning resource

Pts are at their most vulnerable
Higher risk of harm
Staff conflict
Informed and valid consent hard to elicit

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Whistleblowing def

Drs have a professional duty to report colleagues suspected of unfit practice to the GMC

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Public interest disclosure act 1998

Protects whistleblowers against detriment from their employer

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Mid-Staffordshire hospital scandal

A decreased budget and institutional pressure caused an increase in the number of Pt deaths

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Francis report recommendations

Pt put first
Pt protected from avoidable harm
Complaints must be handled effectively
Must be open and transparent when things go wrong

Duty of Candour

Positive legal obligation under health and social care act 2008

Duty of staff to tell Pts about safety incidents

Truth telling

Being open and forthright w Pts

Lying

Making a deliberate false statement

Deceptions

Causing someone to believe something that is false

Evasion

Deception through irrelevant true statements w the goal of avoiding upset

Euphemism

Word or phrase used to avoid saying something potentially upsetting or offensive

Therapeutic privilege

Entitlement to withhold info from a Pt when it is feared that disclosure would cause immediate or serious harm

Autonomous right not to know

Pt have an autonomous right to request not to know information about their health. *if they have capacity*

Mental state

Wellbeing defined in terms of how we’re feeling mentally

Desire-fulfillment

Wellbeing consists of desires being fulfilled and desires restricted Ones revolving around life take priority in best interests

-ves of best interests

Can be very vague and subjective

Complications def

Undesirable and unintended direct result if surgery which wouldn’t have happened had the surgery gone as well as hoped

Error def

Event that would t have happened if all procedures were followed

Never events

Events that can cause serious harm or death that are entirely preventable

Near misses

Adverse events that had potential to cause harm but didn’t

Negligence causes

Judgement errors rather than honest mistakes

Negligence criteria

Practitioner owed a duty of care Duty of care breached Breach of care caused the harm

Criteria when gaining consent for surgical procedures

Warn Pts of risk Detail common consequences Mention surgical risks Tell the truth

Bristol Heart Scandal

Higher death rates amongst babies requiring cardiac surgery Lifted lid on “old boys culture”

Recommendations following Bristol Heart Scandal

Involve pts/public more External monitoring of services Root out unsafe practices and learn from errors

Clinical governance

Framework used in NHS for improving quality of services & ensuring high standard of care

Elements of clinical governance

Education/training Clinical audit Research and development Risk management Info management

Health and social care act

Legislated a reorganisation of the NHS Clinicians put commissioning Aim to empower Pts Need for improvements

Commissioning cycle

Evaluate Initiate INVx Collaborate Incubate Negotiate Activate Consolidate Restart

What did Harry Shipman do?

Forged wills of several Pts and then killed the Pts w/ morphine

What happened after Harry Shipman?

Reform of death certificates

Genetic counselling def

Process of providing info to families affected by genetic disorders so they can understand their available options

Genetic counselling +ves

Increases Pt autonomy Non-judgemental Potential to reduce. Occurrence of serious genetic conditions

Genetic counselling -ves

Difficult process New area of medicine Conflict Impact on insurance

Cultural relativism

Idea that there are no absolute morals or truth

Descriptive relativism

Account of differences in moral standards and beliefs

Cultural imperialism

Culture of one community pushed onto another

What does NICE do?

Produces guidance for England and Wales on technology appraisals, clinical guidance, and interventional procedures