Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision...
-
Upload
suzanna-perkins -
Category
Documents
-
view
214 -
download
0
Transcript of Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision...
![Page 1: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/1.jpg)
Dr.Abedalrahman Shqaidef
Ethics and Risk management
![Page 2: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/2.jpg)
Introduction
Negligence
Risks Encountered as a Clinician
Ethical Decision Making
![Page 3: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/3.jpg)
A large variety of ethical questions (debate euthanasia and abortion).
Developments in high technology medicine present us with many difficult medico-moral questions (defining death, withdrawing life-support, obtaining consent).
The maintenance of standards of care and competence,
Introduction
![Page 4: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/4.jpg)
Risk management is about how to avoid being sued. It involves:
Risk identification, Assessment of the severity of the
consequences of that risk and Formulation of a policy to minimize
the risk
Risk management
![Page 5: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/5.jpg)
Patients may bring a case against a clinician under the law of tort up to four years after the date of knowledge of the injury. A tort is a civil wrong rather than a criminal matter,
Negligence
![Page 6: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/6.jpg)
Types
Intent, e.g. assault.
Negligence. in diagnosis & in
the delivery of treatment.
Strict liability, e.g. problems
arising from the use of dental
products.
![Page 7: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/7.jpg)
In order to prove Negligence a pt must prove
A legal duty of care A breach of that dutyResultant loss or damage
Negligence
![Page 8: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/8.jpg)
Three need to be satisfied:
A duty of care existed between the defendant (clinician) and the plaintiff (patient).
That duty was breached.
There is a close causal link between the breach of duty and injury
Elements
![Page 9: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/9.jpg)
Used to to provide evidence of proper standard of care
RCS England Management of the removal of wisdom teeth
Management Of palataly ectopic canines
Management Unerupted maxillary incisors
Guidelines:
![Page 10: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/10.jpg)
Risks Encountered as a Clinician
ConsentConfidentialityRecord keeping and storageDiagnosisRisks of treatmentDelivery of careTermination of treatmentRisks encountered as an employer or a
selfemployed person
![Page 11: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/11.jpg)
Gillick Competent The case of West Norfolk and Wisbech AHA
(1985) concerned a directive from the Department of Health to general medical practitioners that they were able to prescribe oral contraceptives to girls beneath the age of 16 years without parental knowledge and consent.
Mrs Gillick objected strongly to this and the case was finally decided by the House of Lords.
![Page 12: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/12.jpg)
Consent. . . parental right to determine whether or not their minor child below the age of 16 will have medical treatment terminates if and when the child achieves a sufficient understanding and intelligence to enable him or her to understand fully what is proposed.
![Page 13: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/13.jpg)
ConsentThus, a child could be competent at as young an age as 12 or 13 years, but the complexity/seriousness of the procedure/ operation proposed will obviously have an influence in assessing competence in such a minor.
![Page 14: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/14.jpg)
Record Keeping & Storage
Clinical records should be thorough, legible and complete.
They should be contemporaneous and may be handwritten or recorded on a computer.
a minimum of 11 years following the date of the last entry for adults and,
in the case of minors, for 11 yrs or until the age of 25, whichever is the longer.
![Page 15: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/15.jpg)
DiagnosisIncorrect Dx may include any
aspect of patient care.
It is important that medical
history forms are updated
regularly,
![Page 16: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/16.jpg)
Delivery of Care
The test of negligence is the Bolam test,
Did the clinician act as a body of responsible
clinicians would have acted, and is that action
good practice?
This may be modified if the judge considers the
expert opinion illogical
![Page 17: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/17.jpg)
Risks of Treatment
This highlights the importance of
recording in the patient’s records
every failed attendance and to co-
operate
It is prudent never to guarantee a
result!
![Page 18: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/18.jpg)
Risk Management
Introduction
Negligence
Risks Encountered as a
Clinician
Ethical Decision Making
![Page 19: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/19.jpg)
Solving an ethical problem
![Page 20: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/20.jpg)
A Working ExampleThe recent document released by the National Institute for Clinical Excellence pronounces on criteria to be used when assessing whether or not a patient should have 3rd molars removed.
Such documents should be read alongside anything else of relevance and a dispassionate analysis undertaken.
![Page 21: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/21.jpg)
Decision PrinciplesAutonomy, nonmaleficence, beneficence, and
justice are four generally accepted ethical principles.
All actions should demonstrate:Regard for self-determination (respect for
autonomy); The avoidance of doing harm (nonmaleficence); The promotion of well-being (beneficence); Fairness in the distribution of goods and the
reduction and avoidance of harms (justice).
![Page 22: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/22.jpg)
The ACD TestFor Ethical Decisions
AssessIs it true?Is it accurate?Is it fair?Is it quality?Is it legal?
![Page 23: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/23.jpg)
Communicate
Have you listened?
Have you informed the
patient?
Have you explained
outcomes?
Have you presented
alternatives?
![Page 24: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/24.jpg)
Decide
Is now the best time?
Is it within your ability?
Is it in the best interests of the
patient?
Is it what you would want for
yourself?
![Page 25: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/25.jpg)
This highlights the importance of
recording in the patient’s records every
failed attendance and to co-operate
It is prudent never to guarantee a result!
Risk of treatment
![Page 26: Dr.Abedalrahman Shqaidef. Introduction Negligence Risks Encountered as a Clinician Ethical Decision Making.](https://reader035.fdocuments.in/reader035/viewer/2022070415/5697c02d1a28abf838cd9b91/html5/thumbnails/26.jpg)
Thank you