PPVE Flashcards
Prima facie
Fidelity
Justice
Beneficence
Non-maleficence
Self-improvement
GMC 4 Domains of Good Med Practice
Knowledge/skills
Comms/teamwork
Safety and quality
Maintaining trust
Absolute duties examples
Do not lie
Do not kill innocents
Respect otherw
Absolute duties def
MORAL OBLIGATIONS which must always be fulfilled
Prima facie def
Moral obligations that are binding but may be overridden by pressing duties
Deontology
Follow rules
Utilitarianism/consequentialism
Focuses on result of an action
4 quadrant approach
Medical indications
Patient preferences
QOL
Contextual features
Valid consent
Informed
Pt has capacity
Voluntary
Ongoing
Acts that allow access to med records
Data protection act
Freedom of info
Access to medical records act
Data protection act 1998
Legal responsibility to keep med records confidential
Sharing is permissible for med purposes
Data anonymous unless consent given
Freedom of information act
NHS must provide info to public about itself and respond appropriately to requests of info
Access to medical records act
Allows individual to access medical records for employment or insurance purposes
Access to health records 1990
Provides some individuals with a statutory right to access medical records of deceased
Caldecott guardian
Person responsible for protecting confidentiality and ensuring proper storage of info
Formal curriculum
Intended, offered and endorsed by institution
Hidden curriculum
Unintended learning experiences within medical education
+ves for having access to Pts as learning resource
Entitled
Central to med education
Helps students engage in their own healthcare
-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
Whistleblowing def
Drs have a professional duty to report colleagues suspected of unfit practice to the GMC
Public interest disclosure act 1998
Protects whistleblowers against detriment from their employer
Mid-Staffordshire hospital scandal
A decreased budget and institutional pressure caused an increase in the number of Pt deaths
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
