2nd Edition
100 Cases in Clinical Ethics and Law
A 30-year-old Polish lady is admitted in labour. This is her first pregnancy and she is full term. She is in a lot of pain, her liquor is stained with meconium and the trace of her baby's heart is classified as pathological. Her grasp of English is limited. You have been asked to obtain her consent for a caesarean section…
100 Cases in Clinical Ethics and Law explores legal and ethical dilemmas through 100 clinical scenarios typical of those encountered by medical students and junior doctors in the emergency or outpatient department, on the ward or in the community setting. Covering issues such as consent, capacity, withdrawal of treatment, confidentiality and whistle-blowing, each scenario has a practical problem-solving element, encouraging readers to explore their own beliefs and values including those that arise as a result of differing cultural and religious backgrounds. Answer pages highlight key points in each case, providing advice on how to deal with the emotive issues that occur when practising medicine and guidance on appropriate behaviour.
Making speedy and appropriate decisions, and choosing the best course of action to take as a result, is one of the most important and challenging parts of training to become a doctor. These true-to-life cases will teach students and junior doctors to recognize ethical and legal dilemmas as they arise, and to respond appropriately.
ETHICAL PRINCIPLES
Principlism
Consequentialism
Deontology
Virtue Ethics
Casuistry
Narrative Ethics
Rights and Duties
ETHICS AND LAW IN CLINICAL PRACTICE: HOW TO DEAL WITH AN ETHICAL DILEMMA IN CLINICAL PRACTICE
ETHICS AND LAW IN CLINICAL PRACTICE: BEGINNING OF LIFE
In Vitro Fertilisation
Same-Sex Parenting
Surrogacy
Pre-Implantation Genetic Diagnosis
Moral Status of the Foetus
Termination of Pregnancy
Conscientious Objection
Pre-Natal Injury
Neonatal Care: Legal and Ethical Issues
ETHICS AND LAW IN CLINICAL PRACTICE: CHILDREN AND ADOLESCENTS
Parental Responsibility and Consent
Parental Refusal of Treatment
Request for Non-Therapeutic Treatment
Assessing Competence in Children
Underage Contraception
Adolescent Refusal of Life-Sustaining Treatment
Non-Engagement with Therapeutic Medication
Withholding Information from a Child
ETHICS AND LAW IN CLINICAL PRACTICE: CONSENT, CAPACITY AND REFUSAL OF TREATMENT
Valid Consent to Treatment
Adult Capacity to Consent to Treatment
Consent and HIV
Consent and Coercion
Examination Under Anaesthesia
Refusal of Treatment
Consent and Emergencies
Assessment of Best Interests
Deprivation of Liberty
ETHICS AND LAW IN CLINICAL PRACTICE: CONFIDENTIALITY
Confidentiality
Confidentiality and Children
Access to Healthcare Information
Confidentiality and HIV
Use of Interpreters
Disclosing Genetic Information
Genetic Testing of Children for Adult-Onset Conditions
ETHICS AND LAW IN CLINICAL PRACTICE: NEGLIGENCE
Standard of Care and Negligence
Provision of Information
Out of Your Depth
Reporting Concerns
Making Mistakes and Incident Forms
Complaints
ETHICS AND LAW IN CLINICAL PRACTICE: MENTAL HEALTH
When to Section a Patient Under the Mental Health Act
Appropriate and Effective Treatment Under the Mental Health Act
Medical Treatment for Patients with a Mental Health Disorder
Conflict in Treatment Aims
Treatment for Eating Disorders
Personal Identity
Self-Harm
Covert Medication
ETHICS AND LAW IN CLINICAL PRACTICE: PUBLIC HEALTH
Patients’ Responsibility for Health and Resource Allocation
Managing Patient Expectations
Requests for Expensive Medical Treatment
Prophylactic Surgery
Screening Programmes
Childhood Immunisation
Professional Responsibility to Discuss Obesity
Incentives for Treatment and Health Promotion
Front-Line Staff and Flu Immunisation
Overseas Visitors
ETHICS AND LAW IN CLINICAL PRACTICE: ORGAN DONATION
Organ Donation
Posthumous Organ Donation
Is There a Market for Living Organ Donors?
Social Media and Organ Donation
ETHICS AND LAW IN CLINICAL PRACTICE: END OF LIFE
The Distinction between Acts and Omissions at the End of Life
Quality of Life and Sanctity of Life Judgements
Basic Care and Medical Treatment at the End of Life
Provision of Futile Treatment
Assisted Suicide
Advance Decisions
Advance Decisions and Attempted Suicide
Do Not Attempt Cardiopulmonary Resuscitation Orders
Brainstem Death
After Death – Coroners and Cremation Forms
DUTIES OF A DOCTOR
Compassion and Resilience
Good Samaritan Acts
Delegation and Handover
Professional Responsibility toward an Abusive Patient
Discharge against Medical Advice
Child Safeguarding
Treating Friends and Relatives
Professionalism and Social Media
Doctors and DVLA Regulations
The Role of Clinical and Research Ethics Committees
FAITH, VALUE AND CULTURE
Medicalisation of Human Experience
Jehovah’s Witnesses and Blood Transfusions
Ramadan and Professional Responsibility
Female Genital Mutilation
Childhood Male Circumcision
Disclosure of Diagnosis and Cultural Relativism
Cultural Considerations in Post Mortem Examination
Requests to See a ‘British’ Doctor
Chaperones
Professional Boundaries
Ethical Issues on Elective
Professional Experience of Illness
Glossary of Terms
Resources
Biography
Carolyn Johnston, LLB, LLM, MA, PhD, adviser in medical law and ethics, School of Medical Education, King's College London; senior lecturer, Kingston University; and member of the Institute of Medical Ethics Education Steering Group, UKPenelope Bradbury, MBBS, MA, BSc, MRCGP, GP partner at The Witterings Medical Centre, and GP associate in accident and emergency medicine, Chichester, UK100 Cases Series Editor:Janice Rymer, MD, FRCOG, FRANZCOG, FHEA, dean of student affairs and lead for Twinned Institutions, and professor of gynaecology, King's College School of Medicine, London, UK
"I would highly recommend this book as an excellent introduction to medical ethics in clinical practice… The book’s strengths are its consideration of a wide range of ethical and moral issues that may arise inpatient care, well-targeted as its intended readership of medical students and junior doctors" – (Highly Commended, Basis of Medicine, BMA Medical Book Awards 2016)