Caring for a patient in a hospital can sometimes feel like traipsing through a minefield. Your primary job as a healthcare professional should always be to administer the best medical treatment possible without discrimination. However, some legal complications can make this job more difficult. Ignoring these legalities can land you in hot water, no matter how much you were trying to help.
Every NHS worker comes prepared with the knowledge of how to care for the sick, but some legal and ethical factors can slip through the cracks. Let’s look at a few of these issues so that you are fully aware of all that can arise as you continue to practice medicine.
The biggest buzzword that you will hear from patients and other staff members is consent. Consent boils down to an individual’s right to make an informed decision about their healthcare. You probably have a good idea about basic consent already, but did you know there are three types?
The first type of consent is voluntary consent. This is consent in its most basic form and is given by the individual with a sound mind and body without any influence. The second type of consent is informed consent. This often occurs when there are multiple choices of treatment available. Therefore, you must inform the patient of every possible course of treatment and outline all risks and benefits to give them the best chance of making the choice that suits them. The third type of consent is capacity. Is the patient able to choose for themselves? If not, you will need to ask permission from the next able mind that is closest to the patient. This can be a close friend or family member. Either way, consent must be given at all times.
Refusal Of Care
Now that you understand the patient’s role in consent, you must learn about your ability to treat and care for injured people. The NHS has made it possible for everyone in the UK to receive free healthcare. A person can visit the accident and emergency centre of a hospital and see a medical professional regardless of the severity of their illness. This means that doctors do not need to worry about turning away patients for financial reasons. What’s more, a doctor cannot refuse a patient treatment based on their gender, race, religion, class, or personal background.
However, there are some cases where a doctor may choose not to treat a patient. One of which is in a situation where treatment can make the medical issue worse. These are corner cases, but a doctor does have the ability to assess a problem and inform their patient of the risks of treatment. So long as the patient has been given all the relevant information, a doctor can refuse care to prevent a risky or fateful operation.
Another reason for refusing treatment is because of an ethical dilemma. For example, a doctor may not treat pregnant women if the child can come to serious, life-threatening harm. This only ever happens if the mother can remain fit without treatment, but a doctor can put the welfare of an unborn child first if they deem treatment unnecessary.
Life does go on as normal outside of the hospital, which is why you may come across external legal factors that can affect your ability to practice medicine. For example, it is normal for a doctor to need both parents’ consent to operate on a child that is too young to give consent themselves. However, in some cases of domestic violence, one parent may be under a non-molestation order which removes their ability to give any say on how their child is treated. You can find more information on non-molestation orders at the National Legal Service and how to act by this type of legal process. The important thing is that you are aware of these kinds of court orders and how they can affect your ability to practice medicine.
18 Week Wait
It is normal for patients to have to wait their turn for an operation. Lots of people can have the same illness, and there isn’t an infinite number of resources to go around. A patient that requires urgent care is put on a waiting list based on the date of their submission or severity of their illness. During this time, you will administer medicine to reduce their suffering or tests to see if they need to be moved up the waiting list. For a long, time this has been the most efficient and fair way to approach healthcare.
However, non-urgent issues are treated differently. These issues refer to an illness that will not worsen over time. The maximum wait for a non-urgent patient in the NHS is eighteen weeks. This weekly countdown starts when the hospital receives a referral letter from the patient’s GP and no sooner. This date can be pushed back under specific circumstances, which include patients’ desire to wait, a patient failing to attend mandatory appointments in the run-up to the treatment, or doctors wishing to delay treatment for the benefit of the patient. A good example of this kind of delay is waiting for a patient to lose weight to increase their chances of survival during a risky surgery.
A patient may not like it, but it is NHS policy to make non-urgent cases wait a maximum of eighteen weeks for treatment.
Rights Of Discharge
One major complaint that can arise in a hospital occurs when a patient wishes to discharge themselves early. Of course, everything discussed so far would suggest that a patient can remove consent and leave the building whenever they wish. However, this is not always the only course of action.
A doctor can refuse a patient’s right to discharge themselves if they are concerned for the patient’s welfare or the welfare of those around them. It is not an easy process, especially if the patient is determined to refuse care. Fortunately, the mental health act assessment holds the power to keep patients from discharging themselves against their doctor’s will. This legal act ensures that only patients with the right mental capacity can leave the hospital of their own accord. If they show signs that they are not in the right mind to make a decision, consent will be referred elsewhere.
These cases do occur, but there should be a loved one on hand who only wants what is best for the patient. Hopefully, they will trust you to care for them until you are happy to discharge them.
The world of medicine is always changing, and you may not have had to worry about some of these legal concerns only a few years ago. Thankfully, there are always powers to help you make the right decision. You got into medicine to help people, so this article should give you the tools to continue doing so while protecting yourself from any unnecessary legal trouble. Stay up to date with changing legislation to stay protected further, and try to remember that you are doing a fantastic job. Even the most unruly patients are thankful for your care in the end.