Subjects

• THE DOCTOR AS A SCHOLAR
  • BASIC SCIENCE
    • Medical knowledge: ANATOMY
    • Medical knowledge: PHYSIOLOGY
    • Medical knowledge: BIOCHEMISTRY (inc. Metabolism)
    • Medical knowledge: CELL BIOLOGY
    • Medical knowledge: MOLECULAR BIOLOGY and GENETICS
  • DISEASE MECHANISMS
    • Medical knowledge: PATHOLOGY
    • Medical knowledge: CANCER
    • Medical knowledge: IMMUNOLOGY and INFLAMMATION
    • Medical knowledge: MICROBIOLOGY and INFECTION
  • CLINICAL SCIENCE
    • Medical knowledge: CLINICAL FEATURES of DISEASE
    • Medical knowledge: THERAPEUTIC PRINCIPLES
    • Medical knowledge: NUTRITION
  • POPULATION SCIENCE
    • Medical knowledge: SOCIOLOGY
    • Medical knowledge: EPIDEMIOLOGY
    • Medical knowledge: PUBLIC HEALTH and GLOBAL HEALTH
    • Medical knowledge: PSYCHOLOGY
• THE DOCTOR AS A PRACTITIONER
  • PATIENT ASSESSMENT
    • Clinical skills: HISTORY and EXAMINATION
    • Clinical skills: INVESTIGATION
    • Clinical skills: IMAGING
    • Clinical skills: DIAGNOSIS and REASONING
  • PRACTICAL PROCEDURES
    • Clinical skills: DIAGNOSTIC PROCEDURES
    • Clinical skills: THERAPEUTIC PROCEDURES
  • PATIENT MANAGEMENT
    • Clinical skills: PATIENT MANAGEMENT
    • Clinical skills: PHARMACOLOGICAL THERAPY
    • Clinical skills: NON-PHARMACOLOGICAL THERAPY
    • Clinical skills: SURGERY and ANAESTHETICS
    • Clinical skills: PREVENTATIVE CARE and HEALTH PROMOTION
    • Clinical skills: INTEGRATED HEALTH and COMPLIMENTARY THERAPIES
  • COMMUNICATION
    • Clinical skills: INTERACTION WITH PATIENTS
    • Clinical skills: WORKING IN TEAMS
    • Clinical skills: MANAGING INFORMATION
• THE DOCTOR AS A PROFESSIONAL
  • LEARNING AND TEACHING
    • Professional issues: LEARNING
    • Professional issues: TEACHING
    • Professional issues: REFLECTION and MENTORING
    • Professional issues: EVIDENCE BASED MEDICINE
  • PERSONAL AND PROFESSIONAL DEVELOPMENT
    • Professional issues: PERSONAL ATTITUDES and SELF CARE
    • Professional issues: MEDICAL PROFESSIONALISM
    • Professional issues: INTER-PROFESSIONAL TEAMS
    • Professional issues: RISK MANAGEMENT and PATIENT SAFETY
  • DOCTOR AND SOCIETY
    • Professional issues: ETHICS and LAW
    • Professional issues: GOVERNANCE and AUDIT
    • Professional issues: MEDICAL LEADERSHIP and MANAGEMENT

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DOCTOR AND SOCIETY: Professional issues: ETHICS and LAW

Index

• Ethics and Law

• Ethics and Law
  • Ethics and Obstetrics and Gynaecology
    1. To understand and practice legal responsibilities of health care workers who are HIV positive (I&I 4)
    2. To understand and practise confidentiality and be aware of current legislation concerning confidentiality with particular reference to sexual and reproductive health & HIV medicine (I&I 4)
    3. To understand and practise legal responsibilities relevant to sexual activity and sexual health and HIV care (e.g. issues of consent, disclosure, providing care for minors, people with learning difficulties, suspected abuse, rape) (I&I 4)
    4. Argue pro and con termination of pregnancy. (CSP4b)
    5. Demonstrate knowledge of laws, and systems of professional regulation through the GMC and others, relevant to medical practice, including the ability to complete relevant certificates and legal documents and liaise with the coroner or procurator fiscal wh (YR5intro)
    6. Understand and accept the legal, moral and ethical responsibilites involved in protecting and promoting the health of individual patients, their dependants, the public and vulnerable groups such as children, older people and people with mental illness (YR1intro)
    7. Know and comply with GMCs ethical guidance and standards including Good Medical Practice; Duties of a Doctor Registered with the GMC, and supplementary ethical guidance which describes what is expected of all doctors registered with the GMC (YR1intro)
    8. Know about and keep to the GMC’s ethical guidance and standards including Good Medical Practice, the ‘Duties of a doctor registered with the GMC’ and supplementary ethical guidance which describe what is expected of all doctors registered with the G (YR5intro)
    9. Describe the legal status of the foetus. (CSP4b)
    10. Demonstrate knowledge of laws and systems of professional regulation through the GMC and others relevant to medical practice; including the ability to complete relevant certificates/legal document and liaise with the coroner / procurator fiscal
    11. Understand some of the ethical issues around genetic data and potential risks to the individual (CSP3)
    12. Explain the concept of personhood and describe its relation to the morality of abortion. (CSP4b)
    13. Describe the legal conditions of lawful abortion as outlined in the Abortion Act 1967 (1990). (CSP4b)
    14. Explain the legal status of the woman and of her husband/partner regarding abortion. (CSP4b)
    15. To state the moral difficulties posed by serious personality disorder for the care of those so affected (PSYCH4, PSYCH4)
    16. Describe the duties and rights of the doctor in relation to abortion. (CSP4b)
    17. Outline the principles of the HFEA 1990 concerning research on embryos. (CSP4b)
    18. Identify legal and ethical issues in reproductive medicine, prenatal screening and genetic counselling. (CSP4b)
  • Legal, Moral, Ethical Responsibilities of Patient Care
    1. Demonstrate the importance of making decisions in partnership with colleagues and patients (GP5)
    2. Be polite, considerate, trustworthy and honest, act with integrity, maintain confidentiality, respect patients’ dignity and privacy, and understand the importance of appropriate consent. (YR5intro)
    3. Understand and accept the legal, moral and ethical responsibilities involved in protecting and promoting the health of individual patients, their dependants and the public − including vulnerable groups such as children, older people, people with learnin (YR5intro)
    4. Describe the harm principle and the limits to autonomy (CSP3)
    5. Respect all patients, colleagues and others regardless of their age, colour, culture, disability, ethnic or national origin, gender, lifestyle, marital or parental status, race, religion or beliefs, sex, sexual orientation, or social or economic status. G (YR5intro)
    6. Know and understand the principles of supporting patients’ wishes who are losing or who are deemed not to have capacity including legal power of attorney and court of protection (HCOE4, PSYCH4)
    7. Recognise the duty to take action if a colleague’s health, performance or conduct is putting patients at risk. (YR5intro)
    8. Define ‘ethnicity’, ‘culture’ and ‘racism’. (GEP/HSPH)
    9. Identify the conflict between the individual and society in the context of risk to others (CSP3)
    10. Identify notable patterns of ill-health in relation to ethnicity. (GEP/HSPH)
    11. Outline the steps a doctor should take to ensure that the DVLA is informed about dangerous drivers (CSP3)
    12. Offer explanations for ethnic differences in health. (GEP/HSPH)
    13. Describe the principles of ‘culturally competent’ health care practice. (GEP/HSPH)
    14. Discuss the outlook for low birth weight babies and identify some of the ethical issues (HD2)
    15. Explain the ethical and practical guidelines for interviewing patients (MedSoc1)
    16. Debate ethical issues pertinent to primary care (GPCC3)
  • Truth Telling
    1. Explain in what respects truth-telling is important both to patient and doctor/student. (CSP3)
    2. Give classical justifications for and against deception and assess the strengh and weaknesses of both. (CSP3)
    3. Specify the potential ethico-legal consequences of lying to patients. (CSP3)
    4. Describe circumstances within medicine and surgery in which it would be appropriate to be economical with the truth (CSP3)
    5. Specify the moral and legal problems of respecting a patient's right not to be told the truth. (CSP3)
    6. Anticipate and appropriately respond to situations where patients ask you as a medical student (or doctor) to be truthful about their condition, treatment and prognosis (CSP3)
    7. Outline good policies on breaking bad news (CSP3)
  • Personal Accountability
  • Informed Consent
    1. Can describe the principles and practice of informed consent (SAPOC5)
    2. Explain why obtaining consent is an integral part of successful clinical relationships and the key tenets of GMC policy (FM1)
    3. Differentiate between explicit and applied consent, indicating when each is important (FM1)
    4. Demonstrate how to obtain consent from a patient for interviewing them (MedSoc1)
  • Moral Theories
    1. Understand the nature and outline the various forms of an ethical problem; identify examples of ethical problems in medicine
    2. Explain the interface between medical ethics and medical law
    3. Outline the major moral theories and their criteria of identifying goodness
    4. Give examples of how each of these theories could be applied in medico-ethical decision making
    5. Describe the shortcomings of moral theories and suggest how they could be overcome
  • Research Ethics
    1. Describe some classical examples of abuse in biomedical research and specify why they are abuses. (CSP3)
    2. Explain the change in ethics and law that has occured in the last four decades (CSP3)
    3. Outline the key international and national codes that currently regulate acceptable research (CSP3)
    4. Describe the work of research ethics committees and the structure of a research protocol. (CSP3)
    5. Identify common moral faults in the design of research protocols and explain why they are faults (CSP3)
    6. Describe the standards of confidentiality in relation to the publication of research outcomes (CSP3)
    7. State the circumstances in which biomedical research could be, or ought not to be, conducted on vulnerable individuals (minors and mentally incapacitated patients) (CSP3)
  • Medical Negligence and Malpractice
    1. Describe the duty of care and who has it (CSP3)
    2. Outline the legal conditions for negligence to be established (CSP3)
    3. Explain the Bolitho modification of the Bolam test (CSP3)
    4. Describe situations or res ipsa loquitur (CSP3)
    5. Explain the legal standard of evidence in negligence cases (CSP3)
  • Confidentiality
    1. Evaluate the importance of privacy in personal life, and why this might entail a right to confidentiality (FM1)
    2. Outline why respect for confidentiality is such an important component of successful clinical relationships and of the key tenets policy. (FM1)
    3. Describe the specific duties of medical students as regards confidentiality, and typical dangers of breaching it. (FM1)
    4. Discuss arguments for and against the belief that confidentiality should be broken in the public interests, including the confidentiality of the clinical relationship (FM1)
  • Ethics and Organ Transplantation / Donation
    1. Describe the causes of the organ crisis
    2. Describe the evolution of transplant ethics since 1968. (CSP4b)
    3. Suggest non-commercialist solutions for the organ crisis
    4. Describe extent and explain the causes of the "organ crisis". (CSP4b)
    5. Argue the pros and cons of a regulated market in organs
    6. Outline the possible solutions or approaches to the organ crisis. (CSP4b)
    7. Argue pros and cons of a policy of implied consent (opt-out), for organ donation upon death
    8. Describe the different global trends in organ commercialism, transplant tourism and organ trafficking and outline the principles of the Declaration of Istanbul, the European law, and the UK Law concerning organ commercialism. (CSP4b)
    9. Argue pro and con a regulated market in organs. (CSP4b)
    10. Argue pro and con a policy of implied consent (opt-out) for organ donation upon death. (CSP4b)
    11. Explain why altruistic living unrelated donation (LURD) is a legal FICTION (CSP4b)
  • Disability Discrimination Act
    1. Explain the purpose of the Disability Discrimination Act (BB1)
  • End of Life (inc. Do Not Resuscitate Orders)
    1. Appreciate the principles used in discussing end of life care, CPR, and appropriateness of care with patients and carers. (HCOE4)
    2. Give arguments for and against hastening death of patients in various circumstances (CSP3)
    3. Outline the duties and prerogatives of doctors and the rights of competent patients in relation to the hastening of death and specify the circumstances where they apply (CSP3)
    4. Outline the difference between various forms of hastening death and distinguish between the ethico-legally acceptable ones from those which are unacceptable (CSP3)
    5. Specify the provisions of acceptable Advance Directives, action based on the rule of double effect, DNAR orders, withdrawal of life-saving treatment and non-treatment decisions (CSP3)
    6. Explain the role of relatives in relation to withdrawal of treatment in incompetent adults (CSP3)
    7. Define ethical issues such as the end of life decision. (BB2)
    8. Explain why the cardiac arrest team is NOT called for all patients that have cardiorespiratory arrest. (CR3)
    9. Discuss how the decision not to call the arrest team is made and describe how the patient and their family should be involved in this process (CR3)
  • Ethics and Mental Illness
    1. To describe the key Sections of the Mental Health Act, with specific reference to admission, compulsory treatment and to provide a moral justification for them. (PSYCH4)
    2. Know the indications for, and appropriate steps to be taken when compulsory admission under the Mental Health Act into hospital is required (PSYCH4)
    3. Explain the ethically pertinent difference between mental and non-mental illness (CSP4b)
    4. Outline the hazards that are particular to psychiatry. (CSP4b)
    5. The Mental Health Act for Section 2, Section 3, Section 5(2) (PSYCH4)
    6. Describe the principles and the outcomes of the "care in the community" programme (CSP4b)
    7. The legislative requirements for compulsory admission (PSYCH4)
    8. Deal with dilemmas of confidentiality and detaining patients. (PSYCH4)
    9. Outline the principles of establishing mental capacity in sectioned patients as outlined in the Mental Capacity Act 2007. (CSP4b)
    10. Describe the three sections of involuntary admission as outlined in the Mental Health Act 1983 (2007). (CSP4b)
    11. Outline the conditions that need to be met for involuntary admission. (CSP4b)
    12. Explain the ethical-legal difference between formal and informal patients and between patients with mental illness and those who suffer from organic brain syndromes. (CSP4b)
    13. To indicate how the structure of the Act is designed to try to protect the civil liberties of detained patients. (PSYCH4)
    14. To know the conditions for detention of a patient (PSYCH4)
    15. To specify the implications of serious mental disorder for the interpretation of the duties of clinical care. (PSYCH4)
    16. To state the moral difficulties posed by serious personality disorder for the care of those so affected. (PSYCH4)
  • Ethics and Paediatrics (inc. abuse/neglect)
    1. Identify three distinct groups of minors in relation to mental capacity, consent and refusal of treatment. (CSP4b)
    2. Describe the medical law pertaining to minors and the tension reflected therein between respect for their autonomy and acting in their best interests. (CSP4b)
    3. Discuss the legal and ethical dilemmas of caring for children (HD2)
    4. Explain the legal concept of parental responsibility and its relevance to the consent question. (CSP4b)
    5. Explain how conflicts between the interests of minors and their guardians ought to be resolved. (CSP4b)
  • Elective Ethics
    1. Understand the sustainability of delivering healthcare in resource poor settings
    2. Be aware of the importance of local culture, language and prevalence of local diseases and determinants of health
    3. Familiarise yourself with different ethical scenarios; be able to describe an appropriate response to common ethical scenarios when working abroad

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