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contemporary clinical practice > Social contract > Flashcards

Social contract Flashcards

1
Q

What is the social contract?

A
  • basis for all interaction between professions and society and the relationship between healthcare providers and patients
  • a deal where we are obligated to do things and society rewards us
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2
Q

Societal expectations placed on healthcare professionals / medicine acc. to the social contract

A
  1. Services of the healer
  2. Guaranteed Competency
  3. Altruistic Service
  4. Morality and Integrity
  5. Address the healthcare needs of individual patients and society / promotion of the public good
  6. Transparency
  7. Accountability
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3
Q

Rewards from society acc. to the social contract

A
  1. Status
  2. Respect
  3. Autonomy in practice
  4. Self-regulation
  5. Financial rewards
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4
Q

What is the most basic understanding of professionalism?

A

learning and maintaining specialised knowledge, skills and expertise that benefits members of society
commitment to use this expertise, always, for others

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5
Q

What does “Services of a healer” mean?

A
  • this is the primary expectation - individuals will receive the services of the healer
  • caring and compassionate treatment with confidentiality respected and dignity preserved
  • patients retain control of direction of treatment
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6
Q

What does “Guaranteed competence” mean?

A
  • expects profession to ensure the competence of each physician by setting and maintaining standards for education, training and practice
  • by disciplining incompetent, unethical or unprofessional conduct
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7
Q

What does “altruistic service” mean?

A
  • physicians are empowered to ask intrusive questions and carry out invasive procedures, pts must trust that the physician won’t pursue self-interest
  • not an open-ended commitment that is incompatible with a healthy physician’s lifestyle
  • pervasive nature of conflicts of interest must be recognised and managed by individual physicians if they are to maintain patient trust
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8
Q

What does “morality and integrity” mean?

A

expected to demonstrate this in their practice and their day-to-day lives
if you lose trust this will reflect badly on the profession as a whole

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9
Q

What does “promotion of the public good” mean?

A

it is expected that its members will address the problems faced by individual patients and also concern itself with issues of importance to society (bc of monopoly over practice)

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10
Q

What does “transparency” mean?

A

expected that public membership in regulatory bodies will be significant and that the establishment and maintenance of standards and policy will be done in consultation with public representatives

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11
Q

What does “accountability” mean?

A

physicians recognised that they were accountable to individual patients, to the public for advice on policy and to each other for self-regulation

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12
Q

What is the “duty of candour”?

A

refers to the professional responsibility of openness and honesty required of chiropractors with patients when something goes wrong with their care, which has the potential to cause harm or distress
(Principle B7!!!)

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13
Q

What is the patient-practitioner relationship built on?

A

trust, confidence and trust

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14
Q

What does the integration of candour mean?

A

when pt care goes wrong and they experience or may experience harm/distress as a result, you should:
- tell the pt immediately something has gone wrong
- apologise to the pt
- offer appropriate remedy / support to put matters right if possible
- explain fully to the patient the short + long term effects of what has happened
- if the pt was caused harm and requires medical attention, you must take responsibility for referring for additional care

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15
Q

What is informed consent?

A

A process of communication between you and your health professional that often leads to agreement / permission for care / treatment

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16
Q

What are the virtues of a chiropractor?

A

honesty, integrity, empathy, humility, consideration, compassion

17
Q

What are the prerequisites for consent to be valid?

A
  1. have to be acting voluntarily
  2. have sufficient/balanced information to make an informed decision
  3. be capable of using / weighing up the info provided
  4. have capacity to give consent
    The decisions have to be respected
18
Q

Types of consent

A

explicit, implied

19
Q

Explicit consent

A

when a pt gives you specific permission either in writing or orally.
Only valid if pt knows / understands to what they are consenting

20
Q

Implicit consent

A

when a patient indirectly indicates their agreement to undergo a procedure

21
Q

Stress vs Burnout

A

stress: over engagement, loss of energy, takes a physical toll
burnout: characterised by disengagement, loss of motivation, takes an emotional toll (accumulation of unchecked stress over long periods)

22
Q

Code on burnout:

A

B1: Protect Patients from harm if your health, conduct or performance of that regulated healthcare professional, puts patients at risk

As governed by the code, chiropractors would need to recognise this conflict and refer patients for temporary measures if needed.

23
Q

What are examples of respecting a pt’s dignity?

A

ensure privacy by closing clinic room door, giving the pt an area to speak in confidence, offering a gown, knocking on the exam room door before entering

24
Q

What is “Fitness to practice”?

A

the importance of staying at peak physical and mental performance and well-being as healthcare professionals, pursuing optimal health is essential and a virtue

25
Q

How can burnout and stress affect your performance?

A

with burnout there is a high risk of impairment and /or addiction which can lead to impaired judgement, substandard practices protocols, patient harm

26
Q

What is CPD and how does it relate to the Code?

A

CPD is any type of learning you undertake which increases your knowledge, understanding and experiences of a subset area / role
on-going learning and development process
Principle G, G2 - maintain your knowledge to ensure its up to date

27
Q

Ethical virtues - The Big 4

A

All patient care is embraced by the Big 4
Autonomy, Beneficence, Justice, Non-maleficence

28
Q

The big 4 - autonomy

A

Autonomy - right of self governance
Pt has the ultimate decision-making responsibility for their own treatment

29
Q

The big 4 - Beneficence

A

Beneficence - where physicians provide to their ability positive benefits such as good health, prevention and treatment of harmful conditions
moral duty to provides patients with the best possible course of action

30
Q

The big 4 - justice

A

giving each patient what they deserve
aligns w principle A: treat pts fairly and without discrimination and recognise diversity and individual choice

31
Q

The big 4 - Non-maleficence

A

an obligation not to inflict harm on others
also aligns with A3 - take appropriate action if you have concerns about the safety of a patient

32
Q

What is the role of the British Chiropractic?

A

The BCA is a professional association that represents all chiropractors registered with the association.
Represents the chiropractic profession to the public, encourages use of the profession.
Develops the chiro community by means of CPD and promotion.
Offers active support for BCA members, including legal support / insurance.

33
Q

What is the role of the GCC?

A
  1. The GCC is the chiropractic profession regulating body in the UK
  2. responsible for registering / regulating chiropractors
  3. sets / publishes the code which covers the standards of chiropractic practice and professional conduct, which all chiros must meet
  4. sets educational standards
  5. investigates and takes action if a chiropractor fails to meet professional standards
34
Q

What is the role of the RCC?

A
  1. promote awareness of the profession amongst the public and medical profession
  2. provide diverse and modern CPD opportunities, incl. PRT postgrad training
  3. provides funding for and promotes research
35
Q

4 Elements of patient consent

A

relates to treatment incl. the plan of management, reassessment, etc.
must include full information on nature of care, benefits, risks, alternatives
must be given voluntarily
without misinterpretation / fraud, open, transparent and unbiased

36
Q

Summary of Principle A

A

A: Put the health interests of patients first
This principle ensures that chiropractors involve patients within their care plan, providing opportunities for the patient to put forward their thoughts, concerns and decisions

Patients have to be given high quality care, respect, patient needs to be fully considered

37
Q

Summary of Principle B

A

B: Act with honesty and integrity and maintain the highest standards of professional and personal conduct.
As a chiropractor it is important that all patients are protected from harm and are given the best advice / quality of care available
Means:
must be properly qualified, advertise legally/honestly - Advertising Standards Agency + guidance: CAP code (B3), maintain patient confidentiality, justify/record reasons for refusing / discontinuing care for a patient

38
Q

Summary of Principle C

A

C: Provide a good standard of clinical care and practice.
Safe and competent care is to be delivered to all patients
1. fully up to date records should be taken
2. develop an appropriate diagnosis and create a plan of management to suit
3. ensure all investigations undertaken are in the patient’s best interest

contemporary clinical practice (2 decks)

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