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Practical Guide to Clinical Ethics Support

Section E: Examples of professional guidelines

British Medical Association (BMA)

The following guidelines have been published by the British Medical Association. All the guidelines are available on their web site, http://www.bma.org.uk free of charge.

The Law and Ethics of Abortion, BMA Views

www.bma.org.uk

March 1997

Revised December 1999

  • Legal considerations
  • Conscientious objections clause
  • Ethical considerations
  • Consent
  • Confidentiality

Access to Health Records by Patients

www.bma.org.uk

Revised December 2002

  • Legal rights of access to health records and information
  • Rights under the Data Protection Act 1998
  • Applications for access
  • Information which cannot be disclosed
  • Access to records of deceased patients
  • BMA advice on record keeping

Access to Medical Report Act (1988)

www.bma.org.uk

December 1988

Revised September 1995

  • Consent
  • Individual’s rights
  • Seeing the report
  • Amendments
  • Delayed access
  • Withholding of information

Medical treatment for adults with Incapacity – guidance on ethical and medico-legal issues in Scotland

www.bma.org.uk

2nd Edition October 2002

  • Adults with Incapacity (Scotland) Act
  • Assessment of capacity
  • Adults with capacity
  • Certificate of incapacity
  • Proxy decision making
  • General authority to treat
  • Mental Health (Scotland) Act
  • Special safeguards

Advance Statements – BMA Views

www.bma.org.uk

November 1992
Revised May 1995

  • What is an advance statement?
  • Legal scope of an advance statement
  • Assistance with drafting
  • Healthcare advocates and proxy decision makers
  • Doctors’ responsibilities

Advance Statements about Medical Treatment – Code of Practice

www.bma.org.uk/ap.nsf/Content/codeofpractice

April 1995

  • Making treatment choices
  • Drafting
  • Implementation

Decisions Relating to Cardiopulmonary Resuscitation

http://www.bma.org.uk="">October 1999

  • http://www.bma.org.uk="">Disclosure without consent in the subject’s vital interests
  • http://www.bma.org.uk="">Other disclosures and their safeguards
  • http://www.bma.org.uk="">Examples of disclosure in the public interest
  • http://www.bma.org.uk="">Confidentiality and People Under 16

    www.bma.org.uk

    January 1994

    • Teenage sexual activity
    • Reasons for concern
    • The legal position
    • Consulting another doctor
    • Confidentiality
    • Immature patients
    • Exceptional circumstances
    • Breach of confidentiality

    End of Life Decisions – Views of the BMA

    www.bma.org.uk

    June 2000

    • Refusal of treatment
    • Euthanasia
    • Physician-assisted suicide
    • Withholding and withdrawing life prolonging medical treatment
    • Advance statements

    Parental Responsibility – Guidance from the Ethics Department

    www.bma.org.uk/ap.nsf/Content/Parental
    February 2004

    • What is parental responsibility?
    • Who possesses parental responsibility?
    • Consent from people with parental responsibility
    • What are the limits to parental responsibility?
    • What happens when people with parental responsibility disagree?
    • Some common questions relating to parental responsibility
    • Parental responsibility and Human Rights
    • Competent children and the limits to parental responsibility

    Treatment Decisions for People in Persistent Vegetative State

    www.bma.org.uk/

    Revised June 1996

    • Defining PVS
    • Misdiagnosis
    • Initial assessment and treatment
    • Diagnosis
    • Review of treatment options
    • Views of the patient
    • Views of people close to the patient
    • Views of healthcare professionals
    • Conscientious objection
    • The legal position
    • Use of tissue
    • Research on PVS
    • Pregnant PVS patients

    General Medical Council (GMC)

    The following guidelines have been published by the General Medical Council. All the guidelines are available on their web site, http://www.gmc-uk.org, free of charge.

    Seeking Patients’ Consent: the Ethical Considerations

    www.gmc-uk.org/standards/consent.htm

    November 1998

    • Consent to investigation and treatment
    • Providing sufficient information
    • Presenting information to patients
    • Ensuring voluntary decision making
    • Establishing capacity to make consent
    • ‘Best Interests’ principle
    • Applying to the court
    • Forms of consent

    Confidentiality: Protecting and Providing Information

    www.gmc-uk.org/standards/confidentiality.htm

    April 2004

    • Patients’ right to confidentiality
    • Sharing information with patients
    • Disclosure of information
    • Frequently asked questions

    Withholding and Withdrawing Life Pro-longing Treatments: Good Practice in Decision-making

    www.gmc-uk.org/standards/whwd.htm
    August 2002

    • Guiding principles
    • Good practice framework
    • Areas for special consideration

    Antenatal Testing for HIV

    www.gmc-uk.org
    November 2002

    Priorities and Choices

    www.gmc-uk.org
    July 2000

    • The duties of care
    • The provision of services
    • The role and responsibility of doctors
    • Quantity or Quality?

    Management in Healthcare – the Role of Doctors

    www.gmc-uk.org
    May 1999

    • Managers’ responsibilities - what takes priority when they conflict?
    • When are doctors held accountable for management decisions
    • Protecting patients from serious harm
    • Dealing with colleagues - the role of managers
    • Public health
    • Occupational health
    • Standards of practice
    • Management practice
    • Honesty in financial matters
    • A short selection of publications for doctors in management

    Department of Health (DH)

    The following guidelines have been published by the Department of Health. All the guidelines are available as pdf documents on their web site, http://www.dh.gov.uk, free of charge.

    Seeking Consent Working with Children

    www.dh.gov.uk
    November 2001

    • Who can give consent?
    • Seeking consent
    • Consent to treatment for mental disorder

    Seeking Consent Working with Older People

    www.dh.gov.uk
    November 2001

    • Seeking consent: people with capacity
    • When adults lack capacity
    • Withdrawing and withholding life-prolonging treatment

    Seeking Consent Working with People with Learning Disabilities

    www.dh.gov.uk
    November 2001

    • Seeking consent: people with capacity
    • When adults lack capacity
    • Withdrawing and withholding life-prolonging treatment

    The Use of Human Organs and Tissue. An Interim Statement.

    www.dh.gov.uk
    April 2003

    • Organs and tissues taken in the future
    • Existing stored organs and tissues
    • Genetics research
    • Disposal of tissue

    The Import and Export of Human Body Parts and Tissue for Non-therapeutic Uses. A Code of Practice.

    www.dh.gov.uk

    Royal Colleges and Societies

    The following guidelines are available on the Royal Colleges and Societies web sites free of charge.

    Royal College of General Practitioners

    Confidentiality – Examining the principle of medical confidentiality

    www.rcgp.org.uk
    November 2000

    • Confidentiality
    • Implied consent
    • Explicit consent

    Royal College of Midwives

    Maternal choice and caesarean section

    www.rcm.org.uk

    Umbilical cord blood collection

    www.rcm.org.uk

    Enforced caesarean sections and consent to treatment

    www.rcm.org.uk

    Royal College of Nurses

    Confidentiality – RCN guidance for occupational health nurses

    www.rcn.org.uk

    Royal College of Obstetrics and Gynaecology

    A consideration of the law and ethics in relation to court-authorised obstetric intervention

    www.rcog.org.uk

    April 1994

    • Good practice
    • United Kingdom law
    • Consent
    • Refusal of consent
    • Possible exception to right to refuse consent
    • Court-authorised caesarean section – United Kingdom
    • The Infant Life Preservation Act (1929)
    • Professional ethics

    Confidentiality and disclosure of health information: RCOG Ethics Committee comments on a BMA document

    www.rcog.org.uk

    October 2000

    Royal College of Ophthalmologists

    Guidance on the retrieval of human eyes used in transplantation and research

    www.rcophth.ac.uk

    1998

    • Consent
    • Donor medical assessment
    • Acknowledgement of eye donation

    Royal College of Paediatrics and Child Health

    The British Paediatric Surveillance Unit (BPSU) and patient confidentiality

    www.rcpch.ac.uk

    2001

    • The BPSU mechanism
    • Maintaining confidentiality in BPSU investigations
    • Ethical consent for BPSU studies

    Responsibilities of doctors in child protection cases with regard to confidentiality

    www.rcpch.ac.uk

    Royal College of Physicians

    Guidelines on the practice of ethics committees in medical research involving human subjects

    www.rcplondon.ac.uk
    Third Edition 1996

    Royal College of Psychiatrists

    Good psychiatric practice

    www.rcpsych.ac.uk
    2002

    • The trusting relationship
    • Consent to treatment
    • Confidentiality

    Good practice guide on confidentiality

    www.rcpsych.ac.uk/
    2001

    • Keeping patients informed
    • Consultant responsibility with respect to other professionals in multi-disciplinary teams
    • Disclosure
    • Situations with dual obligations
    • Provision of reports
    • Requests for case notes
    • Child and adolescent issues
    • Issues arising in relation to people with learning disabilities and people with dementia
    • Security and secondary use of patient information

    Royal College of Surgeons of England

    Code of practice for the surgical management of Jehovah’s Witnesses

    www.rcseng.ac.uk
    2002

    • Ethical considerations
    • Legal and consent issues
    • Preoperative considerations
    • Surgical techniques

    Good surgical practice

    www.rcseng.ac.uk
    2002

    • Good clinical care
    • Maintaining good surgical practice
    • Teaching, training and supervising
    • Relationship with patients

    Nursing and Midwifery Council

    Code of professional conduct

    www.nmc-uk.org

    Guidelines for mental health and learning disabilities nursing

    www.nmc-uk.org

    UKCC position statement on the covert administration of medicines

    http://www.nmc-uk.org

    Copyright for Section E is held by The Ethox Centre.