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TOK legal and ethical Flashcards

1
Q

Who has responsibility for explaining the risks of a general

anaesthetic for dental treatment to a patient or parent?

A

The Hospital/ Community Dentist who assesses the patient. The referring GDP. The treating dentist.

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2
Q

In which of the following treatment scenarios for an adult patient, is it inappropriate to delay treatment, if consent could not be attained?

A

Post extraction bleeding. Marked facial swelling or where airway may be compromised.

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2
Q

Your patient has recently appointed her husband and son

as joint welfare attorneys. As her dentist, how should you

decide whose views you must consider when the patient

cannot consent to treatment by herself

A

You should refer to the patient’s individual POA document for specific instructions

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2
Q

Your patient, a nine year old boy, requires an extraction

but is not in pain. He is accompanied by an adult relative

who does not have parental responsibility. To follow legal

best practice, how should you proceed?

A

Delay treatment until parental consent is obtained.

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3
Q

A patient attends with a broken down upper central

incisor. The dentist decides that a crown will be required

to restore the tooth.Which of the following are required

for effective valid consent?

A

Patient given indication of the likely cost of treatment Specific warnings as to risk

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4
Q

While chatting to a patient, your nurse asks if her

husband’s new dentures are still giving him problems. Is

this?

A

A breach of confidentiality

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5
Q

Which of the following are defined as protected

characteristics, according to the Equality Act 2010?

A

Gender Sexual orientation Race

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6
Q

The practice has a policy allowing for time off to attend

medical appointments. The VDP requires to attend a

number of appointments in relation to their gender

reassignment, but is refused This is an example of?

A

Discrimination

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6
Q

Under the Data Protection Act 2018, which of the

following may be found liable for a breach of

confidentiality in relation to the inappropriate disclosure

of a patient’s records?

A

Dental hygienist Dentist Dental receptionist Dental nurse

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7
Q

Written consent is always required for?

A

Treatment under GA

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7
Q

‘Specific’ consent for GA extractions should be obtained:

A

On the day of GA prior to procedure By GDP prior to referral for GA

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7
Q

Any proposed treatment should always be discussed fully

with the patient to ensure that informed consent is

obtained. In addition, the GDC advises that written

consent should also be obtained for which of the following

procedures?

A

NHS treatment under inhalation sedation NHS treatment under IV sedation Private treatment under IV sedation NHS treatment under general anaesthetic Private treatment under general anaesthetic

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8
Q

When obtaining treatment consent for a child who is

incapable of providing consent themselves, consent can be

given by whom?

A

A Step-Father with a parental responsibility agreement A child’s mother

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9
Q

According to the GDC Standards on Consent, which of the

following are “things that patients might want to know”

before consenting to treatment:

A

The cost of proposed treatment The likely prognosis Options for treatment, their risks and potential benefits Whether the treatment is guaranteed, how long it is guaranteed for and any exclusions that apply

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9
Q

Under the Equality Act 2010, age is protected

characteristic only for those over 75

A

False

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10
Q

Under what circumstances is a dentist LEGALLY required to

disclose patients’ personal information to the police?

A

If the police have a court order

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11
Q

A patient you have known for a while and trust suggests

that his marketing firm could increase your profitability by your supplying him with your patient list to do telephone sales of your sundries, toothbrushes etc. Should you?:

A

Explain you have to keep patients records secure and decline

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12
Q

Which of the following is true in relation to consent?

A

What the patient wants to know about their plan should be taken into account The cost of treatment should usually be discussed When obtaining consent, it is legitimate to explain your recommended treatment option

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12
Q

According to ICO guidance, how often should Privacy

Policies be updated

A

Regularly

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13
Q

For computerised patient records, which of the following

are true in relation to the Data Protection Act?:

A

It is a criminal offence to process personal information without being registered with the Information Commissioner. Data must not be disclosed to third parties without prior consent. All staff must be aware of the need for strict confidentiality

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14
Q

To save time you have decided to delegate obtaining

consent to your nurse. In which of the following situation

is this allowable?

A

Never

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15
Q

You are treating a carious tooth on the NHS and consent

has previously been obtained for an amalgam restoration

only. A large carious exposure becomes apparent during

treatment. Which of the following would be appropriate in

relation to consent?:

A

Tailoring the way you obtain consent to the individual patient’s needs Fully documenting the discussions which took place which led to the patient’s decision Explaining your recommended option Discussing the cost of the various treatment options

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16
Q

Which of the following patient information is considered

personal and therefore subject to GDC guidelines

pertaining to confidentiality?

A

Non-payment of fees/account history Appointment times/attendances Name/Address/Registration with practice Pervious Dental History

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16
Q

After transferring records to accurate microfiche you wish

to dispose of a large number of expired record cards. To

comply with legislation which are the acceptable methods

of disposal?

A

Shredded as part of office waste

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17
Q

You place an advert on-line for a new trainee dental nurse

(male or female) to join a progressive, young and dynamic

team. This would be discriminatory on the grounds of

A

Age

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18
Q

Mrs Tsang attends his dentist, a visit instigated by his wife

Mrs Tsang. Mrs Tsang is embarrassed that her husband is

not tolerating his lower denture and would like the dentist

to make a new denture. As a POA for Finance and Welfare,

Miriam’s responsibilities do not entitle her to:

A

Demand the treatment that she feels he needs is carried out.

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18
Q

A regular patient, who is booked in for an examination,

enters your surgery and sits down on the dental chair. By

doing this, the patient is consenting to:

A

A dental examination.

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19
Q

The maximum duration for a certificate of incapacity is:

A

3 years depending on the nature of the illness.

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20
Q

What is ‘’Duty of Candour’’?

A

Discussion of adverse incidents involving the patient.

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21
Q

If a duty of candour incident occurs, the procedure to be

followed

A

Includes notifying the person affected and offering to meet to give an account of what happened Must be carried out by the responsible person Is outlined in the Duty of candour (Scotland) Regulations 2018

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22
Q

GDPR came into force on:

A

May 2018

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23
Q

Privacy notices relating to GDPR must include the following:

A

Who it will be shared with. Retention periods for the data. Explain lawful purpose for which you are processing personal data.

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24
Q

When applying GDPR, consent of the data subject must be

A

Separate from other terms and conditions Specific Given freely Informed

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25
Q

Which of the following are true in relation to GDPR in

dental practices

A

A subject access request by the patient to see their records may be made verbally Practices should have an all-staff data protection and information governance training programme Dental practices carrying out NHS care must appoint a data protection officer

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25
Q

Following treatment the person responsible for the

recording of treatment undertaken on that visit is:

A

The Dentist who performed the procedure.

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26
Q

Under which of the following circumstances may

information be legally divulged?

A

A patient has transferred to another practice and wishes to have a copy of all of her treatment records to take with her.
A dental insurance company request with written consent

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27
Q

You are producing a new person specification for a dental

nurse post in your practice. Which of the following criteria

contravene Equal Opportunities legislation?

A

Under 40 years of age 5 years experience Wheel chair user Female

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27
Q

By law, Civil Partnership is a protected characteristic, but

marriage is not.

A

False

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28
Q

You plan to change the pay rates in your dental practice.

During the process you fail to inform employees about

development opportunities and sources of support. This is:

A

Acceptable

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29
Q

You need to recruit a replacement dental nurse. The

previous employee had multiple absences leading to a

disruption in the service the practice provides and so you

wish to avoid a recurrence. As a preventative measure and

to improve the service the practice provides you ask

questions about the applicants’ health and absences from

work. This is:

A

Illegal under the Equality Act 2010.

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30
Q

The hygienist at the practice is able to carry out normal

day to day activities, but suffers from a mental

impairment. This is defined as a disability under the

Equality Act 2010.

A

False

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31
Q

One of the nurses at he practice has visual impairment,

and feels unsafe walking home alone in the dark. Which of

the following would be a reasonable adjustment on the

part of the practice owner?

A

Agreeing a flexible working pattern for the nurse affected.

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32
Q

When recording consent, which of the following

statements should always apply?

A

The records should include medical history, any radiographs taken Notes on patient discussions should be made Accurate and legible records be kept

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33
Q

A fourteen year old boy attends your surgery with severe

toothache. How should you proceed?:

A

Examine him, fully explain the treatment and proceed if you are happy he understands

34
Q

For which of the following procedures would the GDC

Standards for the Dental Team specify that written

consent must be obtained?

A

Extraction of impacted LL8 extraction under GA General anaesthetic Extraction of LLE under GA

35
Q

For which of the following proposed dental treatments is written consent necessary according to GDC regulations?

A

Fillings and extractions under general anaesthesia Fillings under inhalation sedation Extractions under inhalation sedation

36
Q

An unregistered patient with toothache makes an

appointment and subsequently comes into the surgery

and sits down in the dental chair when called. What

treatment can you carry out without obtaining further

consent?:

A

Examination of the teeth and oral soft tissues

37
Q

Under the public services reform (the Scottish public

services ombudsman) healthcare and whistleblowing

order 2020, who can raise a concern about NHS services

A

NHS volunteers Trainees and students Former NHS employees Current NHS employees

38
Q

The Independent whistleblowing officer

A

Is an NHS authority that facilitates investigation of concerns in Scotland Cannot investigate anonymous complaints Routinely accepts complaints by email and telephone Can investigate health and safety concerns?

38
Q

If a patient has a welfare proxy with the authority to

consent, which of the following statements is/are true?

A

If the proxy refuses, treatment can go ahead if authorized by a practitioner appointed by the Mental Welfare Commission

39
Q

A child does not want orthodontic treatment. His parents

or legal guardians want their child to have straight teeth

and a perfect smile and insist he is treated. You have…?

A

No consent to provide orthodontic treatment for him

40
Q

A Section 47 Certificate (select any/all correct answers)

A

Can be completed on a “Word” document if it follows exactly the wording of the prescribed form

41
Q

Where the adult has no proxy, which of the following is

authorised to provide treatment, subject to certain

safeguards and exceptions:

A

A certificate of incapacity issued by the doctor primarily responsible for the patients care

42
Q

For the purposes of the Adults with Incapacity (Scotland)

Act 2000 the term “incapable” describes an adult:

A

Unable to communicate decisions Incapable of retaining a memory of their decisions Incapable of understanding the consequences of their decisions

43
Q

For an adult with incapacity, what must a dentist consider

before administering treatment

A

The individual’s past wishes The benefit to the individual The procedure that is the least invasive The procedure that restricts the individual’s freedom as little as possible The wishes of the nearest relative

44
Q

Our statutory duty of Candour was provided for in the

Health (Tobacco, Nicotine etc. and Care) (Scotland) Bill,

passed in March 2016. Which of the following Inquiries

and Reports resulted in this legislation?

A

The Francis Report 2013

44
Q

The main recommendations from the 2013 Francis report

of the Mid Staffordshire Trust enquiry included which of

the following?

A

A fundamental shift to a person centred culture Greater cohesion and staff engagement Openness, transparency and candour should exist throughout the system

44
Q

GDPR applies to

A

Controllers and Processors

45
Q

GDPR gives data subjects which of the following

A

The right to be informed about the collection and the use of their personal data The right to erasure or restrict processing in certain circumstances The right to object processing in certain circumstances

The right to withdraw consent at any time (where relevant) The right to access personal data and supplementary information The right to have inaccurate personal data rectified, or completes if it is incomplete

46
Q

Which of the following elements of a record are covered

by the Data Protection Act, if it is all that is held on a

practice computer based management system?

A

Telephone Log Clinical photos Credit rating GDP’s clinical notes Payment history Medical history Family members and relationships Patient’s telephone number and address

47
Q

The partner of a patient phones asking you to confirm the

time of their appointment the following day. Do you…?

A

Tell them you cannot give this information without permission from the patient

47
Q

Which of the following statements is true? The dental

records of a deceased adult person:

A

Can be assessed by a third party under The Access to Health Records Act 1990 Can be disposed of 11 years after patient’s death

48
Q

Clinical records must be (select all that apply):

A

Secure, Dated, Contemporaneous, Legible, Comprehensive

49
Q

Who has primary liability for a VDP’s patient’s dental notes

being written up correctly?

A

VDP

50
Q

The new dentist of a former patient of yours with the

patient’s permission requests the patient’s records. What

records must you release to their new dentist?

A

Copies of all records and radiographs

51
Q

Do the police have access to clinical records?:

A

Yes, if a judge or sheriff so orders

52
Q

Under the Equality Act, a person could suffer harassment

on the grounds of?

A

Age, Sexual orientation

53
Q

You want to change the pay rates in your newly acquired

dental practice and so you arrange private meetings with

each individual team employee to discuss their personal

circumstances and due to the sensitivity of this matter

insist on confidentiality.

A

Illegal under the Quality Act 2010

53
Q

If you suspect a child patient may be suffering neglect,

which of the following is/are an appropriate course(s) of

action?

A

Contact your local child protection scheme Discussing the details with your defence organisation Discussing the details with a colleague

54
Q

On a domiciliary visit to a new patient you notice that the

patient has very poor personal hygiene and is living in

squalid conditions. The patient lives with her son who

claims to have Power of Attorney (POA) for both Welfare

and Finance. The patient is capable of consenting to the

treatment, however, she demonstrates a poor

understanding of the costs involved. What should you do?

A

Contact Office of Public Guardian to confirm POA and contact Local Authority to report concerns

55
Q

GDPR stands for

A

General Data Protection Regulations

55
Q

Which of these is defined as a protected characteristic

within employment legislation?

A

Age Sex Marriage and Civil Partnership

56
Q

Which of the following are correct?

A

It is the responsibility of the practice to determine what reasonable adjustments are required to meet the needs of disabled patients.

57
Q

Which of the following are required in order to have obtained informed consent?

A

Patient understands proposed treatment Patient understands why proposed treatment is needed Patient understands consequences of not undergoing treatment Patient understands potential risks of treatment Patient understands alternative treatments Patient understands risks of alternative treatments

58
Q

An 9 year old girl presents at your surgery having

sustained a large, sensitive enamel-dentine fracture to her

upper permanent central incisor. She attends with her

Aunt with whom she is staying on holiday, her parents are

not contactable. What treatment should you carry out?

A

Treatment you consider to be in her best interests Ideally only treatment that is reversible

58
Q

A child of 15, who is able to understand an explanation,

attends your surgery requiring XLA of a carious tooth. The

child refuses parental involvement in the decision-making

process. Which of the following actions is appropriate?

A

XLA of tooth, document carefully all discussions Explain the possible consequences of the treatment proposed

59
Q

Which of the following pieces of information might help a

patient to make a decision when consenting to a course of

complaint regard GA treatment?

A

The consequences, risks and benefits of the treatment proposed Whether treatment is guaranteed, and any exclusions that might apply Why you think a particular treatment is necessary and appropriate for the patient

60
Q

For which of the following procedures is written consent

essential?:

A

LR4 Extraction with LA under intravenous sedation Impacted LL8 extraction under GA General anaesthetic LL4 Extraction with LA under inhalation sedation

60
Q

A patient’s Medical History can be shared with which of

the following without consent?

A

The patient’s General Medical Practitioner Consultant colleagues on referral

60
Q

You are half way through a root treatment and the patient

wishes to stop due to it being very painful. You are aware

that it would be beneficial for the patient to complete the

treatment. Should you:

A

Acknowledge the patients request and follow their wishes Stop treatment, but explain the possible risks and consequences of not continuing treatment and highlight that the patient is responsible for future problems Document all discussions in the patients notes

61
Q

For a patient’s consent to be valid, which of the following

must apply?

A

The patient must be informed of the risks involved in a procedure You have to believe they are able to understand what is involved in a procedure

62
Q

Consent of the data subject must be

A

Given freely Specific

Separate from other terms and conditions Informed

63
Q

When photographs are taken as part of patient’s

examination and treatment, which of the following

statements apply?

A

If the photograph is to be used for teaching or publication purposes, written consent should be obtained Patient consent must be obtained through an explanation of the purpose of photography

64
Q

Your patient has recently appointed her husband and son

as joint welfare attorneys. As her dentist, how should you

decide whose views you must consider when the patient

cannot consent to treatment by herself?

A

You should refer to the patient’s individual POA document for specific instructions

65
Q

If a Dental Practitioner is unsure if a patient who is

deemed incompetent under the Adult with Incapacity

(Scotland) Act 2000 has a welfare proxy, he/she could

establish the identity of any proxy by contacting a number

of authorities. These include:

A

The patient’s doctor Social Services The Office of the Public Guardian (Scotland)

65
Q

A section 47 certificate issued under the Adults with

Incapacity (Scotland) Act 2000 should:

A

State that the person with incapacity is unable to make treatment decisions Valid for the course of treatment Detail any proposed treatment Only be signed by a dental practitioner if they have completed an approved training course

66
Q

Which statement are true of treatment plans and Section

47 certificates:

A

The authority for carrying out treatment specified can be delegated to other members of the dental team within their competence Even if there is an ongoing treatment plan, it is best to have a separate certificate for a one-off procedure under general anaesthetic

67
Q

The Adults with Incapacity (Scotland) Act 2000 can be

applied to:

A

Patients with acquired brain injury Patients with severe sensory impairment Patients with Dementia

68
Q

The definition of “incapacity” in the Adults with Incapacity

Act includes (Please select all correct options):

A

Being incapable of remembering information for long enough to make a decision Being incapable of understanding the consequences of a decision

69
Q

Mrs Roberts was recently diagnosed with dementia. She

wanted her husband to be able to look after her affairs

should she become more confused. Both Mrs Roberts and

her husband Graham visited the family lawyer and

organised for Graham to be in a position to look after his

wife’s financial and welfare requirements if and when she becomes incapable. As Mrs Roberts’ dentist, which role is it important for you to know that Graham holds?

A

Continuing and Welfare Power of Attorney

70
Q

Under the AWI Act, who is responsible for investigating

circumstances where a person’s welfare may be at risk

(where that person comes within part 5 of the Act)?

A

The Local Authority

70
Q

A data protection officer must

A

Must have knowledge of the data protection law

71
Q

In order to register for Data Protection you must pay an

annual fee to…

A

The Data Protection Commissioner (also known as the Information Commissioner)

72
Q

A breach of confidentiality could lead to?:

A

Prosecution by the Data Protection Commissioner under the 2018 Data Protection Act A complaint to the General Dental Council of professional misconduct Action for damage by the patient(s) or their personal representative(s)

73
Q

Which of the following are appropriate methods for the

disposal of patient records?

A

Private confidential disposal services Shredding

73
Q

For medico-legal reasons, what is the min period, in years,

that adult patient records should be kept in electronic

form?

A

11

73
Q

If there is a breach of data the DCP should inform the ICO

no later than

A

72 hours

74
Q

To comply with the Consumer Protection Act 1987 how

long should you retain an adult patient’s dental records?

A

11 years

75
Q

With respect to writing-up patients’ records which of the

following statements are true?

A

The examining/treating clinician is liable for maintaining his/her own records

75
Q

According to the Information Commissioner’s Office

advice, ‘’the BDA have established he following

recommendation for retention of dental records:’’

A

11 years or until the patient is 25 years of age, whichever is the longer

76
Q

For the purposes of the Consumer Protection Act 1987, a

child patient’s records should be kept for?:

A

11 years or up to age of 25 (whichever is longer)

77
Q

if asked by the Practitioner Services (Dental) to provide a

patient record, how long does a dentist have to supply the

record?

A

14 days

78
Q

Under the protected characteristic of sex, a woman may not be treated less favourably if she

A

Has had a baby in the last 26 weeks Is breast feeding Is pregnant

78
Q

What is considered special category data

A

Ethnic origin Race

79
Q

The definition of a person’s race includes?

A

Nationality Colour Ethnic origin

80
Q

You want to change the pay rates in your newly acquired

dental practice and so you arrange an all employee

meeting to discuss. At the meeting you inform all the

employees to keep the discussion on pay rates confidential

from employees of the competitor dental practice nearby.

This is:

A

Acceptable

81
Q

The dental nurse you have just interviewed and appointed

then informs you that she is pregnant What should you

do?Select all that apply.

A

Inform the unsuccessful candidates that you appreciated their attendance at the interview but that they were unfortunately unsuccessful. Offer the newly appointed nurse a written contract of employment within 3 months of their start date.

81
Q

What course of action could legally be taken by the

employer if a member of staff discriminates against a co-

worker?

A

Verbal warnings Written warnings Dismissal

VT (11 decks)

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