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Now-a-days public are expecting Skills, Knowledge as well as Ethical behaviour from Doctors. This PPT gives the 2 basic principles of Bio-ethics in brief & apt form
Ethics at the End of Life and Introduction to Hospice and Palliative Care for Medical Students. Exploration of feeding tubes, code status, when to stop chemo. Discusses cases and the ethical principles and values that are the basis for disagreement in care and what to do when there is a conflict in ethical principles themselves. Also provides an introduction to decisions of last resort including physician aid in dying, palliative sedation and voluntary refusal of nutrition and hydration.
Presented at Kansas City University of Osteopathic Medicine 10/27/15 in Lecture Series in Bioethics. See live presentation here: https://www.youtube.com/watch?v=Dr3g3PeVKeo
PSYCHO-SOCIAL AND MENTAL HEALTH IN END OF LIFE , PALLIATIVE CARE , HOSPICE CARE selvaraj227
PSYCHOSOCIAL AND MENTAL HEALTH IN END OF LIFE, LOSS, ANTICIPATORY GRIEF, MOURNING , BEREAVEMENT, GRIEF THEORY, END OF LIFE CAREGIVING IN THE FINAL STAGES OF LIFE, PALLIATIVE CARE HOSPICE CARE
1) The Death System and Cultural Contexts
2) Defining Death and Life/Death Issues
3) A Developmental Perspective on Death
4) Facing One's Own Death
5) Coping with the Death of Someone Else
Now-a-days public are expecting Skills, Knowledge as well as Ethical behaviour from Doctors. This PPT gives the 2 basic principles of Bio-ethics in brief & apt form
Ethics at the End of Life and Introduction to Hospice and Palliative Care for Medical Students. Exploration of feeding tubes, code status, when to stop chemo. Discusses cases and the ethical principles and values that are the basis for disagreement in care and what to do when there is a conflict in ethical principles themselves. Also provides an introduction to decisions of last resort including physician aid in dying, palliative sedation and voluntary refusal of nutrition and hydration.
Presented at Kansas City University of Osteopathic Medicine 10/27/15 in Lecture Series in Bioethics. See live presentation here: https://www.youtube.com/watch?v=Dr3g3PeVKeo
PSYCHO-SOCIAL AND MENTAL HEALTH IN END OF LIFE , PALLIATIVE CARE , HOSPICE CARE selvaraj227
PSYCHOSOCIAL AND MENTAL HEALTH IN END OF LIFE, LOSS, ANTICIPATORY GRIEF, MOURNING , BEREAVEMENT, GRIEF THEORY, END OF LIFE CAREGIVING IN THE FINAL STAGES OF LIFE, PALLIATIVE CARE HOSPICE CARE
1) The Death System and Cultural Contexts
2) Defining Death and Life/Death Issues
3) A Developmental Perspective on Death
4) Facing One's Own Death
5) Coping with the Death of Someone Else
In this presentation it has been tried to give a glimpse of different type of consent, how it should be taken, how the patient to be explained, when consent is must and conditions where consent is not required, so as to guide you in your every day practice.
Background of organ transplant infrastructure in the US. Some history. Definitions. Nursing Care of the transplant patient in hospital, and home settings. Intended for senior level nursing students in an ADN program
Medical records means and includes the record pertaining to the admission, diagnosis, treatment, investigation, daily progress, operations, consultations
Assessing Employees’ Understanding of Liability Protections for .docxfestockton
Assessing Employees’ Understanding of Liability Protections for Physicians and Facility
A case of Three Mountains Regional Hospital
Keri King
Deliverable 2
Physician Liability Protection Question 1
In case no fee is charged, does the responsibility of the malpractice carrier change?
In the event a fee is not charged, the responsibility of the malpractice carrier does not change. The reason is that the practitioner would be deemed to have executed the procedure in question. In the context, the expectation would be that the physician endeavors to meet the highest standards of care. If the responsibility was to change, however, the notion would be that the practitioner is motivated by pay to adhere to practice guidelines, which should not be the case.
2
Physician Liability Protection Question 2
Do Good Samaritan laws present an effect of a physician’s protection from legal action?
Good Samaritan laws have an effect of protection of healthcare professionals from legal actions in certain specific circumstances. One such circumstance is during provision of care in emergency circumstances. In legal context, emergency situations may involve the element of confusion and the physician may, therefore, engage in a malpractice against their wish (Bertoli & Grembi, 2018). The laws mentioned previously, however, do not offer protection to physicians in all other circumstances of offering care and physicians should, therefore, exercise caution.
3
Physician Liability Protection Question 3
What is the nature of liability incurred by a physician as a result of diagnosing a patient and recommending treatment without usual diagnostic tests?
Diagnosing a patient without a usual test amounts to neglect of the duty of care to decide the treatment to give to a sufferer. The reason is that a range of ailments can feature similar symptoms and would, therefore, be inappropriate for a medic to settle on treatment without confirmed laboratory results. In like manner, the physician in question would also be liable for breaching the duty of care in administration of treatment. The breach of duties would grant a patient the right of action for negligence.
4
Physician Liability Protection Question 4
In case treatment will be unavailable owing to the patient being uninsured, what would be the use of diagnostic testing?
Usually, treatment is not available to patients that are not insured. In the context, however, diagnostic tests may still be available to the patients despite the absence of insurance, the rationale being that test results may be applied for treatment of the patient in the facility if payment is availed (Schneider, 2017). In a similar manner, the results may be used in another medical facility where a client could be having a cover. In both cases, prior testing saves a client from potential danger of escalation of their problem without knowledge of the disorder they are suffering from.
5
Physician Liability Pr ...
Deleterious Effects Of Antidepressants On Semen Parameters: A Case ReportAhmed Elaghoury
Please cite as follows: Shehatto K, Abed M, Elaghoury A. Deleterious Effects Of Antidepressants On Semen Parameters: A Case Report. Poster presented at: Psychiatry of the 21st Century: Context, Controversies and Commitment. The World Psychiatric Association 17th WORLD CONGRESS OF PSYCHIATRY; 2017 Oct 8-12; Berlin, Germany.
DOI: 10.13140/RG.2.2.15518.64321
Restless Legs Syndrome/Willis-Ekbom Disease (RLS/WED) in the child psychiatry...Ahmed Elaghoury
Please, cite as follows: Elaghoury A, Abed M, Shehatto K. Restless Legs Syndrome/Willis-Ekbom Disease (RLS/WED) in the child psychiatry clinic: an occult and hidden comorbidity.
Poster presented at: Psychiatry of the 21st Century: Context, Controversies and Commitment. The World Psychiatric Association 17th WORLD CONGRESS OF PSYCHIATRY; 2017 Oct 8-12; Berlin, Germany.
DOI: 10.13140/RG.2.2.32295.85921
Sleep disorders with autism spectrum disorderAhmed Elaghoury
اضطرابات النوم لدى أطفال طيف التوحد: كلمة أمام أولياء الأمور، وبعض معلمي التربية الخاصة، وبعض العاملين في مجال الصحة النفسية للأطفال أثناء ملتقى التوحد الأول بالطايف. مستشفى الهدا العسكري
Risk of pulmonary aspiration with the outpatient electroconvulsive therapy: C...Ahmed Elaghoury
A case study presented at the 2nd International Brain Stimulation in Barcelona.
Cite as: Gad, M., & Elaghoury, A. (2017). Risk of pulmonary aspiration with the outpatient electroconvulsive therapy: Case report. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation, 10(2), 419.
http://dx.doi.org/10.1016/j.brs.2017.01.244
The emerging therapeutic role of the non-invasive brain stimulation in the ad...Ahmed Elaghoury
Poster 1.043 presented at the 2nd International Brain Stimulation Conference, Barcelona, Spain on 6th March 2017
Please cite as Elaghoury, A. (2017). The emerging therapeutic role of the non-invasive brain stimulation in the addiction medicine: review of the ongoing studies. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation, 10(2), 454-455. http://dx.doi.org/10.1016/j.brs.2017.01.333
Also, Poster #510 in the 2018 NIDA International Forum
June 8 – 11, 2018
San Diego, California
An interactive case presentation during the monthly meeting of Early-career psychiatrists in Jeddah, SA. Basically, a case managed and supervised clinically by Dr Shokry Alemam, MD
New updates in the concept and clinical usage of "mood stabilizers" based on the new report of WPA section on pharmacopsychiatry, June 2012.
http://1.usa.gov/LrRd3E
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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Consent & confidentiality
1. IT Y
& IAL
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2. PRE TEST
True or False :
3.Legally, consent is only valid when written.
4.Mental capacity is constant in all situations.
5.You can hide information from the patient if these information would harm him.
6.You personal experience is the only key to patient’s best interest.
7.Once the patient agree on a procedure, he have to go through it till the end.
8.You can breach patient’s confidentiality if these information would safe another
person.
9.Confidentiality of psychiatric patients is protected by Egyptian laws
3. GOALS OF THE LECTURE
• Why is consent legally necessary?
• What are the essentials of valid consent?
• How do you assess Mental Capacity?
• Why is confidentiality important?
• When can you breach confidentiality?
4. INTRODUCTION
Mohr v. Williams (1905), the plaintiff consented to
an operation on her right ear. When she was
anaesthetized, her surgeon made the decision to
operate on her left ear instead, because this was
found to be more seriously diseased.
Despite no harm having occurred to the patient, a
claim in battery was successful as the patient had
only consented to surgery on her right ear.
5. CONSENT
• The agreement to a treatment or procedure
• Does not have to be given in writing; it can be given orally
or even implied from the circumstances
e.g. holding an arm out for an injection, nodding the head
• Consent is limited to the procedures which the patient has
been informed of and agreed to. Except in an emergency it
cannot be exceeded to include other procedures
• Consent can be withdrawn prior to the procedure
6. ESSENTIALS ELEMENTS OF CONSENT
• The patient must be competent to give consent.
• It must be voluntary, and not coerced.
• The patient must be provided with information
about the procedure
7. COMPETENCE
(MENTAL CAPACITY)
The Mental Capacity Act 2005 (MCA) states that a person lacks
capacity if they cannot do one or more of the following:
•Understand the information relevant to the decision
•Retain that information
•Use or weigh that information as part of the process of making
the decision
•Communicate the decision (whether by talking, using sign
language or any other means).
8. COMPETENCE
(MENTAL CAPACITY)
Capacity can evolve and fluctuate over time, and treatment should
be postponed if capacity can be restored.
It is task specific – a person may have capacity to make a particular
decision but lack capacity for other more complex decisions.
Before it is concluded that someone lacks capacity to make a
decision all possible steps should be given to help them to reach the
decision
Consider treatment options which are least restrictive of the
person’s rights or future choices and which promote the greatest
freedom
9. COMPETENCE
(MENTAL CAPACITY)
Lasting power of attorney (LPA)
is a legal document which allows a person (donor) to appoint someone to take
decisions (attorney) for him in the event of loss of capacity
Independent mental capacity advocate (IMCAs)
independent advocates who represent the views of vulnerable people lacking
capacity to make important decisions about serious medical treatment when
there are no family members or friends who can be consulted
10. COMPETENCE
(MENTAL CAPACITY)
Ms. B v. NHS Hospital Trust (2002)
Ms. B’, a 43-year-old paralyzed woman who had been kept alive on a ventilator
for 11 months and now wished to be allowed to die. When the hospital trust
looking after her refused to switch the ventilator off, arguing she could not make
a truly informed decision until she had tried special rehabilitation to improve her
condition, Ms. B took the matter to court. In a hearing convened at her bedside, it
was held that not only was she competent to make her own decisions but that,
moreover, the hospital trust had been in breach of the Human Rights Act for
failing to accede to her wishes
11. COMPETENCE
(MENTAL CAPACITY)
‘It is most important that those considering the issue should not confuse the
question of mental capacity with the nature of the decision made by the patient,
however grave the consequences.
The view of the patient may reflect a difference in values rather than an absence
of competence and the assessment of capacity should be approached with this
firmly in mind.’
12. VOLUNTARY DECISION MAKING
It is for the patient, not the doctor, to determine what is in the patient's own
best interests. Nonetheless, you may wish to recommend a treatment or a
course of action to patients, but you must not put pressure on patients to accept
your advice. In discussions with patients, you should:
– Give a balanced view of the options;
– Explain the need for informed consent.
– Declare any conflict of interests
You should not make assumptions about patients' views
13. VOLUNTARY DECISION MAKING
Patients who are detained by the police, or are in
prison, and those detained under the provisions of
any mental health legislation may be particularly
vulnerable. Where such patients have a right to
decline treatment you should do your best to ensure
that they know this, and are able to exercise this right.
14. THE INFORMATION PATIENTS SHOULD KNOW
details of the diagnosis, and prognosis, and the likely prognosis if the condition is left untreated;
uncertainties about the diagnosis including options for further investigation prior to treatment;
options for treatment or management of the condition, including the option not to treat;
the purpose of a proposed investigation or treatment; details of the procedures or therapies involved, including subsidiary
treatment such as methods of pain relief; how the patient should prepare for the procedure; and details of what the patient
might experience during or after the procedure including common and serious side effects;
for each option, explanations of the likely benefits and the probabilities of success; and discussion of any serious or
frequently occurring risks, and of any lifestyle changes which may be caused by, or necessitated by, the treatment;
advice about whether a proposed treatment is experimental;
how and when the patient's condition and any side effects will be monitored or re-assessed;
the name of the doctor who will have overall responsibility for the treatment and, where appropriate, names of the senior
members of his or her team;
whether doctors in training will be involved, and the extent to which students may be involved in an investigation or
treatment;
a reminder that patients can change their minds about a decision at any time;
a reminder that patients have a right to seek a second opinion;
where applicable, details of costs or charges which the patient may have to meet.
15. THE INFORMATION PATIENTS SHOULD KNOW
•You should not withhold information necessary for decision making unless you
judge that disclosure of some relevant information would cause the patient
serious harm. In this context serious harm does not mean the patient would
become upset, or decide to refuse treatment.
•Allow patients sufficient time to reflect, before and after making a decision,
especially where the information is complex or the severity of the risks is great.
Where patients have difficulty understanding information, or there is a lot of
information to absorb, it may be appropriate to provide it in manageable
amounts, with appropriate written or other back-up material, over a period of
time, or to repeat it;
16. تطبيقات من القانون المصرى
القانون المدنى
الرضاء
(مادة ) ٠٩
١( التعبير عن الرادة يكون باللفظ وبالكتابة وبالشارة المتداولة عر ًا، كما يكون باتخاذ موقف ل تدع ظروف
ف
الحال شك ً في دللته على حقيقة المقصود
ا
٢( ويجوز أن يكون التعبير عن الرادة ضمن ًا، إذا لم ينص القانون أو يتفق الطرفان على أن يكون صريح
ي
الهلية
(مادة ) ٥٤
١( ل يكون أهل لمباشرة حقوقه المدنية من كان فاقد التمييز لصغر في السن أو
عته أو جنون
.٢( وكل من لم يبلغ السابعة يعتبر فاق ًا للتمييز
د
17. تطبيقات من القانون المصرى
قانون الحوال الشخصية الجديد
قانون رقم 1 لسنة 0002
مادة )82(
علي الطباء المعالجين ومديري المستشفيات والمصحات علي حسب الحوال
ابلغ النيابة العامة عن حالت فقد الهلية الناشئة عن عاهة عقلية بمجرد ثبوت
ذلك لديهم وعلي المختصين بالسلطات الدارية ابلغ النيابة العامة متى تبين
لهم أثناء تأدية عملهم حالة من حالت فقد الهلية على النحو المشار إليه فى
الفقرة السابقة
20. INTRODUCTION NO 2
• Dr. Hamdy A. Farag , General Manager of Salma Hospital filed a report
against An elected parliament member, accusing him that Mr. A. El
Belkemy wrongfully claimed being attacked, while he had undergone
surgery, believed to be a nose job.
• Dr Hamdy rationalize his actions for the excessive lying of the parliament
member in the media, yet he confirms that Mr. Belkemy told him not to tell
anyone about the operation.
• The member had resigned from his party & the parliament.
21. CONFIDENTIALITY
The obligation to keep safe and secret health information provided in the
course of a professional relationship
Maintaining patient confidentiality is necessary to ensure that patients trust
doctors with personal and sensitive information
22. DATA PROTECTION ACT 1998
The eight principles of good practice
Anyone processing personal information must comply with eight enforceable principles of
good information handling practice.
These say that data must be:
1. fairly and lawfully processed
2. processed for limited purposes
3. adequate, relevant and not excessive
4. accurate and up to date
5. not kept longer than necessary
6. processed in accordance with the individual’s rights
7. secure
8. not transferred to countries outside European Economic area unless country has
adequate protection for the individual
23. THE CALDICOTT GUARDIAN
Acting as the ‘conscience’ of an organization, the Guardian should also actively
support work to facilitate and enable information sharing, and advise on
options for lawful and ethical processing of information as required
24. DISCLOSURE OF INFORMATION
The duty of confidentiality is an important cornerstone
of the provision of medical care but it is not absolute…
Disclosure of Medical data can occur in one or more of
the following conditions
•Having the explicit consent of the individual
•Being required by law to process the information for
employment purposes
•Needing to process the information in order to protect
the vital interests of the individual or another person
•Dealing with the administration of justice or legal
proceedings
25. تطبيقات من القانون المصرى
العلن الدستورى
المادة 11
حياة المواطنين الخاصة حرمة يحميها القانون
وللمراسلت البريدية والبرقية والمحادثات التليفونية وغيرها من وسائل التصال حرمة, وسريتها مكفولة ول تجوز
.مصادرتها أو الطلع عليها أو رقابتها إل بأمر قضائي مسبب ولمدة محددة ووفقا لحكام القانون
26. تطبيقات من القانون المصرى
قانون رعاية المريض النفسى
رقم 17 لسة 9002
مــادة )63( :
بند )81( :
حماية سرية المعلومات التي تتعلق به وبملفه الطبي وعدم إفشاء تلك المعلومات لغير الغراض العلجيه إل فى الحالت التيه :
6.طلب المعلومات من جهه قضائيه.
7.وجود إحتمال قوى بحدوث ضرر خطير أو إصابه وخيمه للمريض أو الخرين .
8.حالت العتداء على الطفال أو الشك فى وجود إعتداء.
9.حق المجلس القومى للصحه النفسيه فى تكوين لجنه فنيه من الطباء المتخصصين يكون لها الحق فى الطلع على سجلت
المرضى طبقا للبند رقم 4 من الماده 7 من هذا القانون
مــادة )93( :
ل يجوز لغير أفراد الفريق العلجي أو القائمين على السجلت الطبية الطلع على المستندات الخاصة بالمريض إل بإذن كتابي منه.
.كما ل يجوز استخراج صورة منها إل بإذن من المجلس القليمى للصحة النفسية
27. POST TEST
True or False :
3.Legally, consent is only valid when written.
4.Mental capacity is constant in all situations.
5.You can hide information from the patient if these information would harm him.
6.You personal experience is the only key to patient’s best interest.
7.Once the patient agree on a procedure, he have to go through it till the end.
8.You can breach patient’s confidentiality if these information would safe another
person.
9.Confidentiality of psychiatric patients is protected by Egyptian laws
28. REFERENCES
• 100 cases in clinical ethics & law
Carolyn Johnston & Penelope Bradbury
• The Caldicott Guardian
Uk Council of Caldicott Guardian
• Data Protection Act
Information Commissioner
• Mental Capacity Act
UK Legsilation
• Seeking patients' consent: The ethical considerations
General Medical Council
بوابة الحكومة المصرية اللكترونية
موقع المصرى اليوم