Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Domain 5 Practical Procedures
- Section 6 Perioperative Care
- Section 7 Comfort and Recovery
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Introduction
- Barriers to Best Practice
- Ward Round Structure
- Other Housekeeping Issues
- Conclusion
- Epidemiology of Infection in the ICU
- Mechanisms of Infection in the ICU
- Approach to Infection Control
- Prevention of Infection in the ICU
- Why Assess Perioperative Risk?
- How Do We Identify High-Risk Patients?
- Population-Based Risk Scores
- Individualised Risk Prediction Models
- Objective Functional Capacity Assessment
- Biomarkers
- Assessment of Frailty
- Limitations of Scoring Systems
- Introduction
- Validity
- Scoring Systems
- Considerations and Limitations
- Disease-Specific Scoring systems
- Introduction
- The Responsibility Spiral
- The Lead Clinician/Clinical Director
- The Importance of Communication in ICU
- Effective Communication with Patients and Their Representatives
- Maintaining Accurate, Legible Legal records
- Teamwork and Collaboration
- Ensuring Continuity of Care through Effective Handover of Clinical Information
- Supporting Clinical Staff outside ICU and Contribution of Appropriate Supervision, Training and Delegation
- Introduction
- Capacity
- Consent
- Best Interests
- Conflict Resolution
- Introduction
- Assessment of Capacity
- Competent Adults
- Adults who Lack Capacity
- Advance Care Plans
- Prolonged Disorders of Consciousness
- Do Not Attempt Cardiopulmonary Resuscitation
- Futile Medical Treatment
- Gross Negligence Manslaughter
- Resources and Rationing
- Introduction
- What Is CoBaTrICE?
- Educational Approaches
- Integration in Clinical Practice
- Conclusion
- 11.1 Leading the Daily Intensive Care Ward Round
- 11.2 Principles and Compliance with Local Infection Control Measures
- 11.3 Principles of Outcome Prediction, Prognostic Indicators and Treatment Intensity Scales and Limitations of Scoring Systems in Predicting Individual Patient Outcome
- 11.4 Scoring Systems for Severity of Illness in Critical Care
- 11.5 Managerial and Administrative Responsibilities of the Intensive Care Medicine Specialist
- 11.6 Communication in Intensive Care
- 11.7 Professional Relationships with Members of the Healthcare Team
- 11.8 Legal and Ethical Issues in Intensive Care
- 11.9 The Legal Framework
- 11.10 CoBaTrICE: The Importance of Learning Opportunities and Integration of New Knowledge in Clinical Practice
- Index
- References
11.9 - The Legal Framework
from Section 11 - Professionalism, Patient Safety, Governance and Health Systems Management
Published online by Cambridge University Press: 27 July 2023
Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Domain 5 Practical Procedures
- Section 6 Perioperative Care
- Section 7 Comfort and Recovery
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Introduction
- Barriers to Best Practice
- Ward Round Structure
- Other Housekeeping Issues
- Conclusion
- Epidemiology of Infection in the ICU
- Mechanisms of Infection in the ICU
- Approach to Infection Control
- Prevention of Infection in the ICU
- Why Assess Perioperative Risk?
- How Do We Identify High-Risk Patients?
- Population-Based Risk Scores
- Individualised Risk Prediction Models
- Objective Functional Capacity Assessment
- Biomarkers
- Assessment of Frailty
- Limitations of Scoring Systems
- Introduction
- Validity
- Scoring Systems
- Considerations and Limitations
- Disease-Specific Scoring systems
- Introduction
- The Responsibility Spiral
- The Lead Clinician/Clinical Director
- The Importance of Communication in ICU
- Effective Communication with Patients and Their Representatives
- Maintaining Accurate, Legible Legal records
- Teamwork and Collaboration
- Ensuring Continuity of Care through Effective Handover of Clinical Information
- Supporting Clinical Staff outside ICU and Contribution of Appropriate Supervision, Training and Delegation
- Introduction
- Capacity
- Consent
- Best Interests
- Conflict Resolution
- Introduction
- Assessment of Capacity
- Competent Adults
- Adults who Lack Capacity
- Advance Care Plans
- Prolonged Disorders of Consciousness
- Do Not Attempt Cardiopulmonary Resuscitation
- Futile Medical Treatment
- Gross Negligence Manslaughter
- Resources and Rationing
- Introduction
- What Is CoBaTrICE?
- Educational Approaches
- Integration in Clinical Practice
- Conclusion
- 11.1 Leading the Daily Intensive Care Ward Round
- 11.2 Principles and Compliance with Local Infection Control Measures
- 11.3 Principles of Outcome Prediction, Prognostic Indicators and Treatment Intensity Scales and Limitations of Scoring Systems in Predicting Individual Patient Outcome
- 11.4 Scoring Systems for Severity of Illness in Critical Care
- 11.5 Managerial and Administrative Responsibilities of the Intensive Care Medicine Specialist
- 11.6 Communication in Intensive Care
- 11.7 Professional Relationships with Members of the Healthcare Team
- 11.8 Legal and Ethical Issues in Intensive Care
- 11.9 The Legal Framework
- 11.10 CoBaTrICE: The Importance of Learning Opportunities and Integration of New Knowledge in Clinical Practice
- Index
- References
Summary
Key Learning Points
1. Professional regulation and legal framework closely interact in providing care of patients in intensive care.
2. Legal and ethical issues closely interplay with common law, statute and public law.
3. The Mental Capacity Act and safeguarding process have introduced a robust decision-making process.
4. Clinicians have to be aware of the legal framework whilst making treatment refusal and life-sustaining treatment decisions.
5. Patients with capacity can refuse or influence any treatment, but cannot demand any specific treatment.
- Type
- Chapter
- Information
- Intensive Care MedicineThe Essential Guide, pp. 761 - 765Publisher: Cambridge University PressPrint publication year: 2021
References
References and Further Reading
Brazier, M, Cave, E. Medicine, Patients and the Law, 6th edn. Manchester: Manchester University Press; 2016.Google Scholar
Danbury, C, Newdick, C, Lawson, A, et al. Law and Ethics in Intensive Care. Oxford: Oxford University Press; 2010.Google Scholar
General Medical Council. 2010. Treatment and care towards the end of life: good practice in decision making. www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/treatment-and-care-towards-the-end-of-lifeGoogle Scholar
General Medical Council. 2020. Decision making and consent guidance. www.gmc-uk.org/guidance/ethical_guidance/consent_guidance_index.aspGoogle Scholar
Laing, J, McHale, J. Principles of Medical Law, 4th edn. Oxford: Oxford University Press; 2017.Google Scholar
legislation.gov.uk. 2005. Mental Capacity Act 2005. www.legislation.gov.uk/ukpga/2005/9/contentsGoogle Scholar
Newdick, C. Who Should We Treat? Rights, Rationing and Resources. Oxford: Oxford University Press; 2005.CrossRefGoogle Scholar
Resuscitation Council UK. Guidance: DNACPR and CPR decisions. www.resus.org.uk/library/additional-guidance/guidance-dnacpr-and-cpr-decisionsGoogle Scholar