1. Ethics And a little bit about law

2. Ethics isnt a woolly subject …

3. You need principles, and you need to think clearly

4. Principles Beneficence Beneficence Non maleficence Non maleficence Respect for autonomy Respect for autonomy Justice Justice

5. Moral theories Virtue (Aristotle) Virtue (Aristotle) Duty (Kant) Duty (Kant) Utility (Bentham, Mill) Utility (Bentham, Mill) Rights (20th century) Rights (20th century)

6. Areas raising ethical considerations Professional duties Professional duties Confidentiality Confidentiality Consent Consent Reproductive issues Reproductive issues End of life issues End of life issues Mental health Children Screening Rationing (resource allocation) Genetics

7. Legal aspects of consent Form of consent (implied or explicit) Form of consent (implied or explicit) Treatment without consent could lead to charge or battery (criminal or civil law) or negligence (civil law) Treatment without consent could lead to charge or battery (criminal or civil law) or negligence (civil law) How much information should we give? How much information should we give? Who can give legally valid consent? Who can give legally valid consent? Who has capacity to consent? Who has capacity to consent?

8. Confidentiality All personal info given to a health professional must be treated confidentially except in particular circumstances All personal info given to a health professional must be treated confidentially except in particular circumstances This includes friends and relatives This includes friends and relatives Duty of confidentiality continues after death Duty of confidentiality continues after death Most breaches of confidentiality are inadvertent Most breaches of confidentiality are inadvertent

9. Exceptions to confidentiality Patients consent Patients consent Need to know Need to know Statutory duty (eg DVLC) Statutory duty (eg DVLC) Instruction from Judge (in Court or via a warrant under Police and Criminal Evidence Act Instruction from Judge (in Court or via a warrant under Police and Criminal Evidence Act Wider public interest Wider public interest Child Protection Child Protection

10. Access to information Data Protection Act 1984 (computer records) Data Protection Act 1984 (computer records) Access to Health Records Act 1991(manual records) Access to Health Records Act 1991(manual records) Access to Medical Records Act 1988 (medical reports) Access to Medical Records Act 1988 (medical reports) Data Protection Act 2000 (access to all records) Data Protection Act 2000 (access to all records) Safeguards against having to disclose harmful or third party information Safeguards against having to disclose harmful or third party information

11. Other important legal areas Mental Health Act Mental Health Act Reproductive Issues Reproductive Issues End of Life Issues End of Life Issues Human Rights Act Human Rights Act

12. Reading Ethics in General Practice - a practical handbook for personal development - Anne Orme-Smith and John Spicer. Radcliffe Medical Press 2001 Ethics in General Practice - a practical handbook for personal development - Anne Orme-Smith and John Spicer. Radcliffe Medical Press 2001 Uzmas confidentiality document Uzmas confidentiality document More scenarios on VTS website More scenarios on VTS website