PPD - SEMESTER 3
- Created by: ggmonkey
- Created on: 09-01-20 17:55
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- Clinical Risk
- Medical Error
- Rarely due to poor performance
- Systematic problems
- Blame culture isn't healthy
- Most people accept that mistakes happen if there's an apology
- Actions:
- NHS Complains
- GMC
- The law
- Civil action
- Criminal action
- Duty of care
- NHS trusts have an umbrella of care for all patients
- GP's are sued directly
- GMC says help if you can, no law to say you hve to
- Could be negligence if you do harm
- But for test
- But for the defendants negligence, would the patient have suffered an injury
- Prescriptions
- If you sign a prescription, you are legallly responsible
- 4 duties
- Correct name and drug
- No contraindications
- Correct dose and directions
- Provisions for follow up
- Limitation period of 3 years after descovering damage
- In neonates, period doesnt start until 18
- Lack of experience take into account but not in a legal setting
- Medical Error
- Ethics of Distribution
- The veil of ignorance
- What a just system would look like
- We know nothing of wealth, status, ethnicity...
- We would create a system which was fair
- Caters for poorest, weakestt, disables
- Consequentialism
- What a rational person would agree to
- Plurism
- Recognises diversity
- Time is the most important resource
- Laws
- Recognise need for prioritisation
- Favour efficacy
- Transparent and resonable decision process
- Health & Social Care Act 2012
- Secetary of state must promote improvement in physical & mental health and in prevention, diagnosis and treatment of illness
- The veil of ignorance
- End of life ethics
- Palliative care
- Cloak of comfort, relieves pain and reduces symptoms
- Question of when to begin can cause anger or anxiety
- Descision based on the fact that treatment is not in the best interest
- Holistic view - effect of last stages on life as a whole
- Affirmation of whole person
- Types
- Suicide
- Legal, self-directed, injurous
- Assisted suicide
- Delibrerately assisting someone, illegal
- Acompanying someone to a country where euthenasia is legal
- Delibrerately assisting someone, illegal
- Euthenasia
- Ending life for their benefit, illegal
- Active - Life terminative medication
- Passive - witholding life saving medication
- Voluntary - at own request
- Involuntary - without consent
- Suicide
- Act is permissible if the double doctrine effect is met
- The nature of the act is not bad
- At least one of the consequences are good
- At least one of the consequences are bad
- Serious reasons for bad consequences to occur
- Agent intends good consequence
- Director of Public Prosecutions (DPP)
- Factors in favour of prosecution
- Person under 18
- Capacity
- Motivated by gain
- Persuasion, coersion or pressure
- Motivated by gain
- Capacity
- Person under 18
- Doctors cannot assist in suicide
- Factors in favour of prosecution
- Palliative care
- Confidentiality
- Why do we have it?
- Breach of trust
- Human right
- Embarassing
- Healthcare could not be optimised without
- GMC - Regulator
- NHS/DoH - Employer
- BMA - Trade union
- NHS/DoH - Employer
- Definately should NOT breach
- Gossip
- Irrelevant people
- Definately should breach
- Births/Deaths
- Terrorism
- Fertility/Abortions
- Drug addiction
- Poisoning/Work accidents
- Maybe should breach
- Common Law
- Public interest in keeping confidentiality
- Public interest in protecting individuals
- Statute Law
- Family rights to privacy
- Right to life and freedom
- Compelling circumstances of serious harm
- Disclosure to only those in vital need of information
- Common Law
- Why do we have it?
- VS
- VS
- Consent
- Previously: Patients willing to tolerate medical tyrany.
- What does it mean?
- Voluntary agreement
- Permission to examine
- Waive right to bodily integrity
- Now, individual knows best about their own health, doctor there to advise
- What does it mean?
- Valid consent
- Legal
- Criminal law - assult and battery
- Same as anyone else
- Civil law
- Battery
- Explained in broad terms
- Battery
- Criminal law - assult and battery
- Professional
- GMC guidelines
- Ethical
- Autonomy and rights model
- Legal
- Features
- Informed
- PARQ
- Procedure, Alternatives, Risks, Questions
- Proffessional standard
- What do other proffessionals say? Previous law
- Prudent person standard
- What would a prudent person want to know? DoH
- Subjective standard
- What should be done? GMC
- PARQ
- Voluntary
- Patient able to refuse
- No pressure/coersion
- Competance
- Task specific
- Can fluctuate, time of day, confusion
- Informed
- Issuses
- Sometimes consent is not possible
- Presenting information can be complex and time consuming
- Previously: Patients willing to tolerate medical tyrany.
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