What is article 2?
The right to live
What is article 3?
The right to be free from inhuman and degrading treatment
What is article 4?
Prohibition on slavery and enforced labour
What is article 8?
The right to respect for privacy and family life
What is article 12?
The right to marry and found a family
What is article 14?
Right to enjoy freedom and rights without facing discrimination of sex, race, colour, language, religion, political opinion, birth or other status
What are the duties of a doctor?
- Knowledge, skills and performance
- Safety and quality
- Maintaining trust
What are the 4 ways in which things go wrong?
- Human error
- Neglect
- Poor performance
- Misconduct
How can human errors occur?
- Communication issues
- Judgement
- Ommisions
- Lapses
- Violations
What is neglect in relation to the duties of a doctor?
-Falling below an accepted standard of performance
ie Mid-staff scandal - pts left in dirty bed sheets, drinking water out of flower vases
How can you tell if a dr/staff member is poorly performing?
- Attitude problem
- Rudeness
- Scruffiness
- Failure to learn from mistakes
- Actions affect patient’s care
What are some examples of misconduct?
- deliberate harm
- fraud/theft
- improper relationships
- lack of condour ie hiding mistakes
What questions needs to be asked to determine negligence?
- Was there a duty of care?
- Was there a breach in the duty of care?
- Did the patient come to any harm?
- Did the breach cause the harm?
What is Bolam’s test?
-In any negligence case, would a group of reasonable doctors do the same?
What is bolitho’s test?
-Would it be reasonable for a group of reasonable drs to do the same action as someone on trial for negligence?
What does depriving someone of their liberty mean?
-Taking away someone’s (pt with a mental health disorder) freedom (in a carehome/hospital) as it’s in their best interests and needed to keep them safe when all other options are exhausted
How can you identify when someone’s liberty has been taken away?
- When the pt is not making any decisions for themselves anymore
- when the pt is not allowed to leave
- when the pt is unable to return to home with friends/family
When can DOLS be put in place?
- if its in the pts best interests and protects them from harm
- it’s proportionate response to the likelihood and seriousness of harm
- there is no other less restrictive alternative
What are the principles of the mental capacity act?
- Individuals are presumed to have capacity
- All practical steps must be taken to support someone in decision making
- A person is not deemed to be lacking capacity if they make an unwise decision
- An action taken on behalf of a person must be in thier best interests
- Action taken must be the least restrictive of a person’s rights and freedom
How do you assess someone’s capacity?
- Understand the information given to them
- Retain the information given to them long enough to make a decision
- Weigh up the information to make a decision
- Communicate their decision
What is the representative called if someone is under Dols?
Independent mental capacity advocate
How is Dols put in place?
The managing authority (hospital/carehome) need to apply to the local authority who will carry out an assessment to determine the risk to the pt and decide whether authorisation should be issued
What criteria needs to be complete for authorisation of DOLS?
- The pt must lack capacity
- Pt must have a mental disorder
- All other management plans must have been attempted and exhausted
- A best interests assessment and mental health assessment must be completed
- dols is in the person’s best interest
Definition of Dols?
-Deprivation of liberty that occurs when a person who lacks capacity to agree to the arrangements for necessary care or treatment is:
1. Under continuous/complete supervision
AND
2. is not free to leave (regardless of whether they want/attempt to)
