The document discusses several key legal and ethical aspects of medical practice. It outlines 3 main duties of clinical care - protecting life and health, respecting patient autonomy, and ensuring fairness and justice. It also discusses informed consent, medical negligence, legal concepts like duty of care and tort, and challenges like medical reports, certificates, and terminal illness cases. Ensuring ethical practice is important to maintain trust in the doctor-patient relationship and avoid legal issues.
The objective of this presentation is to make you aware of issues which are generally confronted during medical practice.
SOURCES OF LAWS:
PRIMARY SOURCES
Laws passed by the Parliament or the State Legislative
Ordinances passed by the President and the Governor
Subordinate legislation: Rules and regulations made by the executive through the power delegated to them by the Acts.
SECONDARY SOURCES:
Judgments of the Supreme Court, High Court and Tribunals (The ratio decedendi is a binding precedent)
Judicial legislation
Judgment of Foreign Courts
International Treaty
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.
The objective of this presentation is to make you aware of issues which are generally confronted during medical practice.
SOURCES OF LAWS:
PRIMARY SOURCES
Laws passed by the Parliament or the State Legislative
Ordinances passed by the President and the Governor
Subordinate legislation: Rules and regulations made by the executive through the power delegated to them by the Acts.
SECONDARY SOURCES:
Judgments of the Supreme Court, High Court and Tribunals (The ratio decedendi is a binding precedent)
Judicial legislation
Judgment of Foreign Courts
International Treaty
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.
detail knowledge of medico-legal cases, introduction,types, reports, consent,death certificate, patient right. it will help you to understand the concept of medico-legal cases
Patient Rights, Patients Bill, ConSumer Protection Act, Nurse and Patient Bill of Rights,
Hospital and Bill of Rights for Patient, Rights of the Pateint, Legal Issues for Patients
Duties and obligations of a Doctor as per Medical council of Inida (MCI) / State medical council (SMC), Moral & Legal responsibility of a Doctor, MCI Ethics Regulations 2002 (including amendments), Duties towards patients, Duties towards Public, Duties towards another Doctor, Duties towards Law, Duties towards society, Rights & Privileges of a Doctor in India.
CODE OF ETHICS: The guiding principle in nursing
code are the direction of conduct , understanding of what is right and wrong while providing care in the hospital and community settings.The ICN code of ethics are the milestone to establish nursing as a profession.
concept of health & Illness, health illness continum, prevention and its levels, body defence, health care team, health care delivery system, health care agencies
detail knowledge of medico-legal cases, introduction,types, reports, consent,death certificate, patient right. it will help you to understand the concept of medico-legal cases
Patient Rights, Patients Bill, ConSumer Protection Act, Nurse and Patient Bill of Rights,
Hospital and Bill of Rights for Patient, Rights of the Pateint, Legal Issues for Patients
Duties and obligations of a Doctor as per Medical council of Inida (MCI) / State medical council (SMC), Moral & Legal responsibility of a Doctor, MCI Ethics Regulations 2002 (including amendments), Duties towards patients, Duties towards Public, Duties towards another Doctor, Duties towards Law, Duties towards society, Rights & Privileges of a Doctor in India.
CODE OF ETHICS: The guiding principle in nursing
code are the direction of conduct , understanding of what is right and wrong while providing care in the hospital and community settings.The ICN code of ethics are the milestone to establish nursing as a profession.
concept of health & Illness, health illness continum, prevention and its levels, body defence, health care team, health care delivery system, health care agencies
The good doctors is who is good in relationship to his patients what ever the reason. but do not use your relationship to date a girl in as your her doctor unless you finish that relationship as a medical doctor.
There are a law and ethics that protects the patients and the doctor relationship to prevent the damage or suit for both of them.
As there is relation b/w the patient and doctor there is also a relation b/w doctor and another doctor and this is important both of them to take a care for patient.
Any misunderstanding of both doctors should try to solve it because we do not need to harm the patient.
Malpractice should not allowed in the field of medicine because your are dealing with humans life.
The malpractice is due to lack of doctors knowledge, uninteresting the sensitive cases, not using a guidelines.
The most type and common error in malpractice is the medication error and could put the patient's life risky.
Medical record is important why because you follow up the patients and will help you to guide and known the status the patient whether he or she improving or not.
There are several types of medical record: by using paper or documented book or by using electronic such as computers and so on.
If you are recording the patient information the patient will trust you and so happy because you still remember him or her information and this is good for you.
The legal implications of nursing practice are tied to licensure, state and federal laws, scope of practice and a public expectation that nurses practice at a high professional standard. The nurse's education, license and nursing standard provide the framework by which nurses are expected to practice.
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.
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.
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
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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
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1. LEGAL ASPECTS
OF Medical Care
Prof. Syed Amin Tabish
FRCP (London), FRCP (Edin.), FAMS, MD (AIIMS)
2. Legal Aspects of Medical
Practice
• With knowledge explosion and
technological advances mainly
aimed to provide high quality
medical care to individual
patients, the need for a careful
construction of a professional
ethics is urgent.
• Citizen’s charter on Health
Services
• Consumer Protection Act
4. The Duties of Clinical Care
Rights of patients may be
summarized by 3
corresponding duties of
care which apply to all
patients:
- Protect life & health
- Respect Autonomy
- Fairness & justice
5. 1. The Duties of Clinical care
• Protect Life & Health
(clinicians to practice
medicine to high standard
not to cause unnecessary
harm/suffering
6. 2. The Duties of Clinical Care
Respect Autonomy:
• Humans have autonomy – the
ability to reason, plan and make
choices about the future
• Doctors are required to respect
these attributes (respect for the
dignity):
- informed consent
- confidentiality (per info)
Denying pts. Such choice & control
robs them of their human dignity
7. 3. Fairness & justice
• The access to & quality of clinical care
should be need-based rather than
favoritism
• Injustice can occur through treating
patients unequally according to:
- socioeconomic status
- physical attraction
- profession
- age
- race
Equal Access to appropriate care
according to NEED
8. Why should Doctors take these
duties seriously?
• Professional regulation (Medical
Council)
• The Law (duties are also enshrined
in the constitution/statue/common
law)
- Doctors may be sued in Civil
Law for financial compensation for
any harm (failure in professional
duty)
- If this harm is intentional:
Criminal Law will apply
9. Why should Doctors take these
duties seriously?
• Rational Self-interest: support
the right of all patients to high
standard of care
• The clinical importance of trust:
lack of trust will spoil the quality
of pt. care & professional life
• The Doctor-Patient Relationship:
treat pts. As active partners in
healing process; Problem-solving
is by doctors; Decision-making is
by both (Doctor & Patient)
10. Medical Mistakes
Clinical Negligence
• Patient must provide
evidence to the Court that:
- they were harmed
- the harm was caused by
the accused doctor
- the action that causes the
harm was a breach of
professional duty
11. Challenges
• Consent
• Medical negligence
• Medical reports
• Certificates
• Sexual offenses
• Confidentiality
• Terminal illness
• Withdrawing of life-support
12. Ethics is everyone’s responsibility
• The relationship of patient to
his physician is by its very
nature one of the most
intimate
• Foundation: doctor is learned,
skilled & experienced in
afflictions of body about which
patient ordinarily knows little
(but are very imp for him)
13. Ethics is everyone’s
responsibility
• Patient must place great
reliance, faith & confidence in
the professional
word/advice/acts of doctor
• Doctor must act with utmost
good faith & to speak fairly &
truthfully to the peril of being
held liable for damages for deceit
or fraud
14. Fundamental Right
• No person shall be deprived of
his life (life with human
dignity)
• Emergency care is right of
every citizen
• When a person who is innocent
or criminal has met with an
accident, it is the obligation of
health providers to protect his
life
15. Emergency Doctrine
• In Emergencies, CONSENT can be
implied in the law if immediate
treatment is necessary to avoid
life- or limb-threatening
condition
• Clinical management should
precede the legal duties in
trauma cases brought for
treatment
16. Medical Negligence
• A doctor must posses a
reasonable degree of
proficiency & apply the
proficiency with a reasonable
degree of diligence
• Failure of the doctor to provide
medical services (with requisite
skill & care) gives rise to action
in medical negligence under
criminal, civil or consumer court
17. Medical Negligence
• A doctor is negligent if he
doesn't offer his services in
an emergency situation
• A doctor breaches his duty of
care when he fails to reach
the standard of proficiency
expected of him
18. Legal concept of Negligence
• Human Behaviour towards
others: failure to act reasonably
& prudently
• Failure or breach of duty owed to
the patient doctor has the
obligation to perform that duty in
a manner that will bring it to a
successful conclusion)
• Damage to the individual for
breach of duty (there must be some
damage to the patient resulting from breach
of duty owed)
19. Medical malpractice
• The plaintiff must prove that the
treatment given was below the
degree and skill expected of a
competent doctor and that the
negligence proximately caused
the injury or death……….. The
bare possibility of causation will
not suffice
20. TORT
• Civil wrong (negligence) committed
by one individual against another is
known as TORT, where, a person fails
to take proper care, so that damage
results
• Civil Law deals with legal actions
which seek the redress of wrongs
which are not criminal in nature
• Criminal Law involves a legal action
filed by a state government against
defendants and deals with definitions
of crimes and their punishment
21. Negligence
• Harmful conduct that deviates
from accepted standards of duty
& care
• A doctor who injures a patient by
conduct that fails to meet the
legal standard of due care may
be liable for negligence in an
action for malpractice
22. Specific elements of Negligence
In order for a complaining party to
sustain an action for negligence against
a defending party, 4 elements must be
proved in the court of law:
• Existence of doctor-patient relationship
giving rise to a duty of due care
• Breach of that duty
• Proximate cause (injury): Fall from a
Stretcher in ED sustains bruises/MI after 4 months;
is unlikely to rove that the fall caused MI
• Damages
23. Res Ipsa Loquitur
• In most malpractice cases, the
plaintiff is required to prove
negligence through the testimony of
an expert medical witness
• An exception: doctrine of res ipsa
loquitur (the thing speaks for itself):
when medical mishap could not be
due to someone’s negligence
(presence of a sponge or clamp in the
body cavity of a patient who has had
surgery is a self-evident indication of
negligent conduct by some member of
the operating team)
24. Error of Clinical Judgment
• Some mishaps are unavoidable,
being within the wide range of
variability and uncertainty that is
inherent in biological processes
• Common causes for negligent
actions include failure to attend,
amputation of wrong limb or
digit, missed fractures,, tight
plaster casts, poor results from
spinal procedures, damage to
newborn from anoxia or forceps
25. Error of clinical judgment - II
• Removal of healthy kidney
instead of pathological
• Operation on healthy eye
• Leaving gauze or instrument in
the body cavity during surgery
• Anesthetic errors
• Not performing sensitivity tests
for certain drugs before
administering
• Failed tubal sterilization
26. Malpractice
• Professional negligence
• Lack of reasonable care &
skill
• Willful negligence in the
treatment of a patient
whereby the health or life of
a patient is endangered
27. Criminal Negligence
• Negligence is so great as to go
beyond matter of mere
compensation
• Not only the doctor has made
wrong diagnosis and treatment,
but he/she has shown gross
neglect for life and safety of the
patient
• Doctor may be prosecuted for
having caused injury or death of a
patient by a rash & negligent act
amounting to culpable homicide
28. CONSENT
• One of the most basic human rights
is freedom from physical interference
• A person of sufficient maturity and
mental capacity can choose whether
to submit to the ministrations of a
doctor
• With few exceptions, consent to
examination is an absolute
prerequisite before a doctor
approaches the patient
• Failure to obtain consent may lead to
recovery of damages in a civil action
29. Battery
•Battery: an unpermitted
contact with the patient
•A clinician who fails to
obtain consent for
treatment or who provides
treatment beyond or
contrary to what the patient
has consented to
30. Types of Consent
• Implied Consent: is provided by the
behaviour of the patient; e.g. patient
presents at Outpatient Clinic
• Express Consent: Any thing other
than implied consent. It may be oral
or written
• Informed Consent: consent must be
obtained after a reasonable
explanation of the proposed
procedure to patient, so that he is
enable to make informed decision
whether or not to submit
31. The Extension Doctrine
• Provides an exception to the general
rule that a patient’s consent is limited
to those procedures contemplated
when consent is given
• If in the course of authorized medical
intervention a doctor discovers a life-
threatening condition that requires
immediate treatment and the patient
is unable to consent (e.g. under
anesthesia), the doctor may extend
the operation or procedure without
the patient’s express consent
32. Therapeutic privilege
• A situation where full disclosure to the
patient might be harmful and therefore
contraindicated, a doctor may have a
therapeutic privilege to withhold
information
• This privilege avails only when the
patient’s distress and apprehension are
so great that full disclosure of all risks
might cause emotional harm or induce
the patient to refuse treatment, fail to
cooperate with treatment, or make an
irrational choice of treatment
alternatives
• Used in rare circumstances only
33. Medical reports & certificates
• Reports on the medical conditions
of a person (victim or
accused)folowing injury
• Death certificate
• Reports for Life-insurance
• Certificate of illness
• Certificate of fitness
• All these documents must be
prepared with meticulous accuracy
34. Sexual Assault (Rape)
• Rape is a legal conclusion and not
a medical diagnosis
• The medical diagnosis of a rape
victim should be limited to the
actual clinical findings at the time
of examination
• If MoH trust female Gynecologist
fail to reach the fact definitely, or if
circumstances so demand, take the
judge permission to have the
victim examined by male forensic
doctor
35. Medical Exam. of a female
The medical examination by a
Gynecologist or Forensic
Doctor of a woman subjected
to sexual assault shall be
done in presence of:
• guardian
• female general practitioner
• nurse
36. Report
Incidents requiring a report to
the proper official relevant
agencies while maintaining as
much patient confidentiality as
possible, include:
• Drug & chemical poisoning
• Road traffic accident
• Gun-shot wounds
• Physical assault
37. Gunshot & Stab Wounds
•Reports of these acts of
violence are usually made
to police
38. Dead-on-Arrival
• If the case of death is natural, death
certificate & burying license must be
submitted to relatives
• Un-natural death: be reported to police
for possible investigation & for
assessment of need for a referral to
forensic medicine sp.
• Initiate resuscitation unless it is clear
that patient has been dead for some
time
• Mention that deceased was brought
dead
• Body to be examined by a committee
• In case there is no clear cause of death,
take 50 ml blood in plain tube & send to
Toxicology Centre
39. Cause of Death
• In case the results (from
toxicology lab) are negative, the
cause of death can be mentioned
as “Death possible due to hidden
disease leading to
cardiopulmonary arrest”
• All dead bodies should be kept
for 2 hours before transferring to
mortuary
• Patient’s belongings should be
handed over to relatives, if the
cause of death is natural.
40. Medico-legal cases
• A case or injury or ailment
where an attending doctor after
taking history & clinical
examination of the patient,
thinks that some investigation
by law-enforcing agencies are
essential so as to fix
responsibility regarding the case
in accordance with the law of
the land
41. Medico-legal cases
• Motor vehicle accidents (RTAs)
• Factory/industry accidents
• Suspected homicide, suicide
• Poisoning
• Burn injuries
• Injury where foul play is suspected
• Sexual offenses
• Unconscious cases where cause is not
known
• Cases brought dead with improper
history
• Cases referred by Court
42. MLC Injury Report
• Must be prepared on the appropriate form
• Should be written in a neat and legible
handwriting by the examining doctor
• Report should be completed as early as
possible after examining the person
• Time of examination along with date
• Where nature of injury cannot be
ascertained, patient must be kept under
observation and admitted in ward
• General physical examination should
always be undertaken & findings recorded
• Opinion will depend on X-ray & other
reports
43. Preservation of trace evidence
• All clothing worn by an
injured and removed in the
hospital shall be preserved,
packed after drying
• Gastric lavage, bullet pellets
etc. taken out of the body of
a patient be preserved in
sealed containers & labeled
properly, preserved under
safe custody
44. Doctor’s Defence
• When something untoward
happens following a diagnostic or
therapeutic procedure, the doctor
must take following step/s:
– complete the patient’s record & recheck
the written notes
– be frank enough and inform clearly of the
mishap and show genuine concern about
the unfortunate mishap
– contact professional bodies to seek advice
– professional indemnity insurance cover