Truth-telling, duty of candour, and raising concerns Flashcards
If a doctor is contemplating giving a patient a difficult diagnosis, what is 1 ethical reason against and 2 ethical reasons for disclosure?
Disclosure will cause distress
Non-disclosure will cause worse medical problems
Non-disclosure fails to respect autonomy
What are the 3 different conceptions of honesty?
Don’t lie
Must respond truthfully when asked
Must not withhold relevant / important information
What is the therapeutic exception?
A legal and ethical concept that allows a doctor to withhold certain medical information from a patient if disclosing it is deemed likely to cause significant harm or distress to the patient
The GMC offers guidance about how to be honest using 4 stages – what are they?
TELL the person when something has gone wrong
APOLOGISE to the person
OFFER an appropriate remedy or support to put matters right (if possible)
EXPLAIN fully to the person the short and long term effects of what has happened
The GMC states that what 3 things constitute a proper apology?
What happened
What can be done to deal with any harm caused
What will be done to prevent someone else being harmed
What is a low harm notifiable safety incident?
Any patient safety incident that required extra observation or minor treatment and caused minimal harm
What is the consequence of a low harm notifiable safety incident?
Disclosure required under the professional duty of candour – incident should be reported to National Reporting and Learning System (NRLS)
What is a significant harm notifiable safety incident?
Corresponds with NRLS ‘moderate’, ‘severe’, and ‘death’ and with incidents notifiable to CQC with harm explicitly defined to include ‘prolonged psychological harm’ in line with CQC reporting practice
What is the consequence of a significant harm notifiable safety incident?
Disclosure required under both the professional and organisational duties of candour, with proportionate regulatory consequences for a failure to disclose harm of this kind
