The Scope And Limits Of Personal, Professional & Legal Responsibilities For Doctors And Medical Students

Question 1

What is the good Samaritan act?

Answer 1

Doctors have a professional duty to stop and assist but not a legal duty

Question 2

What is the consequentialist ethical argument for anyone assisting?

Answer 2

May save/prolong life or avert harm/suffering but it doesn’t take into account acts/omissions

Question 3

What is the deontological (duty-based) ethical argument for everyone assisting?

Answer 3

Duty derived from relationship as fellow citizen i.e. you would want others to help if it were you

Question 4

What is the virtue ethical argument for everyone assisting?

Answer 4

Compassion/kindness

Question 5

What is the consequentialist ethical arguments for doctors assisting?

Answer 5

Drs have greater ability to help due to more knowledge/skill/experience

Question 6

What is the deontological ethical arguments for doctors assisting?

Answer 6

Professional duty of care

Question 7

What is the virtue ethical arguments for doctors assisting?

Answer 7

Virtues particularly expected of Drs

Question 8

What is the legal position for doctors to assist?

Answer 8

There is no LEGAL obligation in the UK but for there to be one, there already must an established professional duty of care e.g. situation arising in a hospital setting

Question 9

When might GPs be contractually obliged to help?

Answer 9

1. During core hours

2. Emergency is within their practice area

Question 10

What is the legal position if a doctor does stop to assist?

Answer 10

Legal duty of care is established and normal standard of care test applies (though dependent on context) when it comes to negligence claims - must only act within clinical competence

Question 11

When does the Social Action, Responsibility and Heroism Act apply?

Answer 11

When a court is determining the steps a person was required to take to meet a standard of care considering:

• Was the person acting for the benefit of society?
• Did the person demonstrate a predominantly responsible approach?
• Was the person acting heroically?

Question 12

What is the professional guidance on doctors assisting?

Answer 12

You must offer help if emergencies arise in clinical settings or in community taking account of own safety, competence and availability of other options for care

Question 13

How should medical students act in emergency situations?

Answer 13

Somewhere between doctor and bystander - must avoid providing routine care that is outside their competence level but if a patient is at immediate risk of death or serious harm the medical student can help if they believe they can improve outcomes

Question 14

What does the NHS litigation authority do?

Answer 14

Provides indemnity for clinical negligence claims but ONLY for those duties listed in doctors contract (not necessarily Good Samaritans acts)

Question 15

What does indemnity not cover?

Answer 15

Disciplinary issues by employer
Referrals to GMC
GP contractors, locum GPs + salaried GPs

Question 16

When does indemnity not apply?

Answer 16

Contract work for any other agency
Voluntary/charity wok
Overseas work

Question 17

Who can provide additional indemnity (e.g. Good Samaritan acts)?

Answer 17

Medical Protection Society or medical defence organisations such as the Medical Defence Union

Question 18

What should you remember in one of these situations?

Answer 18

Your clinical competence
Consent
Case notes
Communication
Clinical negligence

Question 19

What is informal medicine?

Answer 19

Treatment or consultation given without the usual record-keeping or follow up

Question 20

Who should you avoid providing medical care to as stated by professional guidance? When does this not apply?

Answer 20

Yourself

Anyone with whom you have a close personal relationship

UNLESS IT IS AN IMMEDIATE EMERGENCY SITUATION

Question 21

What are the arguments for treating acquaintances, friends and family?

Answer 21

• Relationship of trust between Dr and patient
• Greater understanding of person and context by Dr
• Leads to better standard of care
• Reduced burden on NHS

Question 22

What are the arguments against treating acquaintances, friends and family?

Answer 22

• Emotional involvement may lead to lack of objectivity
• Assessment at home not as good as in clinical setting so standard of care may be lower
• Impaired relationship with own GP
• Confidentiality
• The Dr may not wish to explore sensitive topics
• Patient may feel unable to refuse treatment or seek alternatives

Question 23

When considering patient and public trust in the profession, what is something you can do to keep personal and professional boundaries?

Answer 23

Making social media accounts as private as possible

Question 24

When would it be inappropriate to have a personal relationship with a former patient?

Answer 24

1. Length of time since the professional relationship ended
2. Nature of previous professional relationship
3. Whether patient was particularly vulnerable at the time of the professional relationship and whether they are still vulnerable
4. Whether you will be caring or for other members of the patient’s family