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33 Cards in this Set

  • Front
  • Back
Data protection guidelines
- Only used for indicated purpose
- Available to the person described
- Any factually incorrect data corrected
- Destroyed once used
- Not to be disclosed without consent
- Kept for no longer than necessary and kept up to date
- Must be processed by entities registered with the information commissioner's office
The doctrine of double effect
Describes the balance between good and bad, or positives and negatives, of any procedure or medication. The obvious desire is for the good to outweigh the bad, i.e. if an antibiotic kills one person due to a drug reaction but saves 10 due to it's anti-pathogen effect, it is intrinsically good.
Acts vs omissions
In certain contexts, failure to perform and act, with certain foreseen negative consequences of that failure, is less morally bad than to perform an act which has the identical foreseen bad consequences.

i.e. It is better to allow somebody to die than to kill them.
Role of a coroner
Coroners are government officials who investigate human deaths, determine the cause of death, issue death certificates, maintain death records, respond to death in mass disasters, identify unknown dead and perform other functions according to local law.
Definition of infertility
A couple who have failed to conceive when trying for over 12 months, or with more than 3 miscarriages
The HFE Act 1990
Prohibits human cloning, the placement of non-human embryos inside a woman's uterus.

DIY insemination (i.e. lesbian couple using a friend for sperm) is not prohibited or regulated
HFE Act 2008 amendments
- Creation and use of all human embryos outside the human body are subject to regulation

- Ban on sex selection of offspring

- Added requirements for clinics to take account of the welfare of the child

- Removed requirement for clinics to account for the child's 'need for a father'

- Legal recognition of both partners in a same sex relationship as legal parents of children conceived through ART
Section 2 of MHA 2007
Allows for a 28 day detention which is approved by 2 doctors for a pt w/ a mental health disorder warranting admission
Section 3 of MHA 2007
Allows for a six month detention period which is renewable at the end of the 6 months. Application must be supported by 2 doctors.
Section 4 of MHA 2007
Allows for emergency detention for 72 hours supported by 1 doctor but does not allow for compulsory treatment.
Define equipose
Equipoise is the concept that there is a genuine uncertainty over whether a treatment will or will not be beneficial. Once there is significant evidence the research is usually stopped since clinical equipoise is no longer met.
Five things for the research ethics committee to take into account when assessing new trials
1. Relevance
2. Risk/benefit ratio
3. Methodology
4. Quality of facilities
5. Adequacy of procedures for obtaining consent
The three R's of animal research
Replacement where possible non-animal methods could be used. Reduction in the number of animals used (i.e. keep to a minimum). Refinement - keep pain and distress to a minimum and for a justifiable purpose.
Purpose of medical records
1. Facilitate accurate and effective communication with other healthcare professionals

2. For storage and recall of background information

3. For clinical governance

4. To provide a legal record of patient care
Define parentage with respect to ART
The legal mother is the one who gives birth to the child, irrespective of whether or not she received an oocyte donation or is a surrogate. The donor of the oocyte or sperm has no legal rights over the child. The male partner who is receiving treatment services with the woman and has consented to this will become the legal father of the child, regardless of whether or not the child is the product of his sperm. This means that a child may not necessarily have a legal father. A child cannot have multiple legal mothers or fathers.
Role of the HFEA
- To license and monitor clinics and facilities

- To license and monitor research involving embryos

- Maintain a register of licenses held by clinics, research establishments and storage centres

- Regulate storage of gametes and embryos

- Keep a confidential register about donors, patients and treatment

- Provide impartial and authoritative information to the public and patients about ART and embryo research
Capacity
Assessments should only be carried out when there is legitimate doubt about a persons capacity and not just because they disagree with the clinician.

It is a clinical skill, i.e. not to be left to psychiatrists
Maximising capacity
Gauge capacity at an appropriate time and location. Treat any inhibiting conditions. Use visual/learning aids if necessary. Also, translators.

Give the pt adequate time to understand the information and communicate their decision.
Arguments for the 'duty' approach to Global Health Justice
Utility - Poor, sick people have a greater need for health care and thus should gain greater access on utilitarian grounds

Rights - Everyone has a right to basic health care

Justice - The wealthy of the world harm the poor (nature of capitalism, i.e. unjust trade tariffs etc.) and thus owe the poor health care as a form of rectification
Requirements to obtain a license for animal testing
Applicants must...

- understand the ethical debate surrounding animal research

- Have a working knowledge of the law surrounding animal research

- Understand the health and safety surrounding animal research

- Understand minor/common surgical procedures, anaesthesia, analgesia and humane euthanasia

- Have a practical knowledge of animal handling
Who has access to medical records?
- Patients

- Parents of patients under 18 if acting in the child's best interests and not against the wishes of a competent child

- Lasting power of attorney for an incapacitous adult

- Other health care professionals

- Other relatives have NO special rights

- Lawyers require consent from the patient

- Police only have access in serious cases

- The media should NEVER have access

- Insurance firms and employers can only gain access with the consent of the patient

- Confidentiality continues even when the patient is deceased
Two aims of reporting a notifiable disease
1. Enable the prompt investigation, risk assessment and response to cases of infectious diseases and contamination

2. Providing data for use in the epidemiological surveillance of infection and contamination
How does the notifiable diseases system work in the UK?
1. A registered medical professional has a 'reasonable ground for suspecting' that a patient has a notifiable disease

2. The registered medical professional has a statutory duty to notify a 'Proper officer' of the local authority - a consultant in communicable disease control

3. The proper officer will investigate further and initiate a response if needed and will send a report to the centre for infections which is part of the health protection agency

4. The HPA collates all reports and publishes an analysis of trends and responds to the case if need be
Time limits for reporting a notifiable disease
3 days maximum for a registered medical professional to report the case in writing.

24 hours maximum for urgent cases to be reported initially by phone
Is HIV a notifiable disease?
NO!!
Difference between a reportable disease and a notifiable disease
A reportable disease is a disease that may have been caused by employment, thus necessitating the reporting of the employer to the Health and Safety Executive
Powers of detention regarding notifiable diseases
An application can be made under section 37 of the 1984 act to a justice of the peace for a part 2A order to detain a patient where:

- proper precautions to contain a notifiable disease are not being taken
- there is serious risk of infection to others
- accommodation in a suitable NHS hospital can be made available

Section 38 provides that a patient who is already in hospital and suffering from a notifiable disease can be detained if on leaving the hospital the patient would not have accommodation in which proper precautions could be taken to prevent the risk of infection

Section 40 allows for the compulsory examination of a patient found in a common lodging house with a view to ascertaining whether he or she is suffering from or has suffered from a notifiable disease.

There is no statutory provision allowing for compulsory treatment.
Legal criteria for a lawful termination of pregnancy
Approved by two doctors (unless an emergency) and performed by a registered doctor on an approved site.

Can be justified because:

- Risk of injury to physical or mental health of woman or existing children

- Prevent grave permanent injury to mental/physical health to the pregnant woman

- Risk to life of pregnant woman

- Risk to foetus of permanent handicap

- Immediate emergency (one doctor required)
Human tissue act 2008
- Consent the most important principle for the lawful retention and use of human tissue

- Offence to transplant organs unless the regulations of the act are adhered to

- Offence to be involved in the sale of any organs in any way

- Tissue must be used safely, ethically and with consent
Aim of British welfare state
social class differences in health would be narrowed following the provision of free comprehensive medical care for the whole population
Explanations of health inequality identified by the Black report
1. Data errors

2. Social or natural selection i.e. those with poor health being downwardly mobile

3. Cultural explanations - class differences in health beliefs and behaviour

4. Material circumstances - social differences in income, diet, housing and working environment are key determinants
Acheson reports recommended interventions
Medical care at the level of morbidity to prevent an early death.

Preventative approaches to change individual risk

Improve psychological circumstances in workplace

Reduce social and economic inequalities in social structure
Main themes of the 2003 programme of action
1. Supporting families, mothers and children

2. Engaging communities and individuals

3. Preventing illness and providing effective treatment and care

4. Addressing the underlying determinants of health principles