8 novembre 2022
Legal Issues in Operation Theatre
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A 72-year-old woman suffered burns after a fire was set while undergoing surgery in an operating room at Sunshine Hospital. The fire started when medical equipment was not working, only. Before a procedure can be performed on a patient, their consent to this measure must be obtained. If a patient undergoes surgery without consent, the surgeon is guilty of assault (except in an emergency) (Lord Scarman, 1985). Obtaining consent is therefore both a legal and ethical obligation. An important aspect of the physician-patient relationship is the need for mutual trust and respect, which is built into the process of obtaining informed consent. Ethically, the need for consent is part of the principle of patient autonomy (Beauchamp & Childress 2013), in which the patient has the full right over his or her own body to decide what should and should not happen to him. The patient`s doctor can advise and facilitate the patient`s decision-making, but he cannot force the patient to make a particular choice. A prerequisite for the validity of consent is that it is given voluntarily, that the patient has the capacity to do so and that he has received sufficient information to understand the nature of the treatment and the consequences of its acceptance and rejection. The Ministry of Health has created standardized consent forms for use in practice, although there is no legal requirement that consent be given in writing or in a specific form. Proper documentation of consent in written form seems prudent and is certainly in line with most, if not all, of the NHS local guidelines on the subject. In surgery, checking whether the patient has completed a consent form is also part of the World Health Organization`s Surgical Safety Checklist (WHO 2009), which has been implemented to ensure safer surgical protocols worldwide and has been integrated into NHS practice via national safety standards for invasive procedures and subsequent local guidelines (NHS England). 2015).
Under the Mental Capacity Act 2005 (Care Quality Commission 2017), preliminary rulings are a legally binding expression of a person`s wishes regarding their end-of-life care and, in particular, the treatments they wish to accept or refuse, such as respiratory support or cardiopulmonary resuscitation. Decisions are recorded in a formal document when the patient is considered legally capable – in anticipation of a time when they will no longer be able to express their wishes. The preliminary decision must be made in writing and signed by the patient, and then signed by a witness. TOLEDO, Ohio (WTVG) — A Toledo plastic surgeon was arrested Friday by the FBI on charges of illegal distribution of controlled substances, aggravated sexual abuse and sex trafficking. Dr. Manish, 49 years old. The president of Massachusetts General Hospital has long insisted that it is perfectly safe for some surgeons to supervise two surgeries at the same time. Dr. Peter Slavin told The Globe. Fortunately, important clinical decisions (such as whether a patient should have surgery) are not left to one person – there is a team approach. The « heart team », a multidisciplinary group used for decision-making, not only to know who to operate, but also when and by whom, provides a balanced decision-making process (Head et al.
2013). The team can follow guidelines and assess current evidence regarding individual patients, which can help reduce the frequency of inappropriate treatments. But just because the patient`s case has been discussed and the most appropriate treatment has been agreed by the cardiac team doesn`t mean we automatically take this course of action. It is always necessary to have a clear discussion with the patient to inform them of the treatment options for their condition. This discussion will also be part of the process of obtaining informed consent, which is both a legal requirement and an opportunity for the patient to consider not only the proposed procedure, but also all other factors associated with it. 9. The team will effectively communicate and share critical patient information for the safe execution of surgery. A 2-year-old boy who was scheduled to undergo « minimal surgery » was « sterilized » when doctors accidentally operated on the wrong testicle, his family said. The boy was treated for. In fact, the ten main goals presented above largely reflect what was already happening in theater – before, during, and after surgery. However, they also provide a useful template that the whole team can work on. The main message is the importance of safe practice.
The practical implementation of the target is done through a checklist, and the best is, of course, the WHO checklist for surgical safety (WHO 2009). This checklist has three main sections (login, timeout, and logout), and these three sections are guided by three principles: simplicity, general applicability and measurability (WHO 2008). The checklist was adapted by the National Patient Safety Agency (NPSA 2009) – see Figure 2.1 for example. This chapter discusses the legal and ethical considerations that guide us and guide us in our practice in cardiothoracic surgery. Throughout our practice, the overarching goal must be « do no harm » (Brazier & Cave 2016), not only during surgery, but also in the preoperative and postoperative planning phase of the patient journey. We are governed by the British legal system, which guides us in criminal and civil matters. There are many laws relating to professional work in health care. There are also professional codes that regulate and regulate practice, such as those of the Council of Nurses and Midwives (NMC 2015) and the Health and Care Professions Council (HCPC, 2016).
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