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
11.8 - Legal and Ethical Issues in Intensive Care
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. The capacity to make an autonomous decision is central to all of modern medicine.
2. Valid consent requires the voluntary decision of an individual with capacity who has been given adequate information.
3. When a patient lacks the capacity to consent, then the justification for treating them is best interests.
4. Mediation is a process where the two (or more) sides of a dispute have a structured conversation to try and find a mutually acceptable resolution.
5. The results of mediation showed that between 60 and 90 per cent of disputes settled without the need to go to court.
- Type
- Chapter
- Information
- Intensive Care MedicineThe Essential Guide, pp. 758 - 760Publisher: Cambridge University PressPrint publication year: 2021
References
References and Further Reading
Azoulay, E, Timsit, J-F, Sprung, CL, et al. Prevalence and factors of intensive care unit conflicts: the Conflicus study. Am J Respir Crit Care Med 2009;180:853–60.CrossRefGoogle ScholarPubMed
Canadian Centre for Elder Law. 2012. Report on elder and guardianship mediation. papers.ssrn.com/sol3/papers.cfm?abstract_id=2008347Google Scholar
Danbury, C, Newdick, C, Waldmann, C, Lawson, A (eds). Law and Ethics in Intensive Care. Oxford, NY: Oxford University Press; 2010.Google Scholar
Health and Social Care Information Centre. 2010. Hospital Episode Statistics. Adult Critical Care in England – April 2014 to March 2015. files.digital.nhs.uk/publicationimport/pub19xxx/pub19938/adul-crit-care-data-eng-apr-14-mar-15-rep.pdfGoogle Scholar
Sprung, CL, Cohen, SL, Sjokvist, P, et al. End-of-life practices in European intensive care units: the Ethicus study. JAMA 2003;290:790–7.CrossRefGoogle ScholarPubMed