ByDr Farah Salwani bt.Muda@Ismail

Medicine provides means for human to overcome the perils of life:disease,accidents, genetic defects…

The medical practitioner is always seen as an honored citizen, recognized for healing skills and curing illnesses

Medical law-concerned with the responsibility of members of the medical profession for their actions, esp when adverse results arise due to human error, negligent or simply natural physical reaction of the patient towards treatment.

Law are rules or actions prescribed by the authority such as the Federal Government and the court system have a binding legal force

Medical law addresses legal rights and obligations that affect patients and protect individual rights, including health care employees.Eg: practising without a license, medical fraud, medical negligence, patient rape, are all illegal, unethical and immoral

The law provides a yardstick to measure our actions.

It provides punishments when laws are broken

Now, there is always a conflict between autonomy and paternalism-either the consent of the patients in all matters is required or one should be allowed to decide on behalf of others, in the name of the other’s best interest, without having any concern to their views or preferences.

Patients are often treated without adequate explanation of what was involved and significant facts about their illness were kept from them.

Information was not passed on the ground that it might cause distress

But, now this is considered unethical, patients do have the right to know about their health condition.

The art of communicating is a skill that needs to be developed

Communication must be effective and meaningful

Words chosen correctly, tone set correctly and level adjusted according to the patient’s level of understanding

Patients are always anxious to know about their illness and health status

Talk to them kindly, with respect, answer all their questions and clarify all doubts

However in some cases, when patients are mentally disturbed or have psychiatric illnesses, it is better not to tell them of their condition

Patients must know and clearly understand what is going to be done and why.

The positive and negative implications must all be disclosed

However, the patient need only be told of information as much as what they need to know.

Sometimes, too remote complications need not be highlighted as it can possibly scare of the patient, resulting to refusal of treatment or surgery

To be on the safe side, medical practitioners should jot down important points already discussed with the patient, in the patient’s notes

Patients should also have the chance to seek for a second opinion.

When such request is made, the med prac must not feel offended, but instead should facilitate the patient in doing so.eg: provide referral letters

The med prac giving the second opinion should ethically return the patient to his primary doc after the consultation , with a letter to continue further treatment

Ever since the Hippocratic oath, 2500 years ago, confidentiality has been recognized by the medical profession as good clinical practice

“I will respect the secrets which are codified in me, even after the patient has died”

Under the common law, confidentiality may be enforced by an injunction or with an action for damages in a civil court.

Disclosure can be resisted if it may cause a breach of confidentiality to a third party who is not a healthcare professional

Consent must be obtained from the patient for this.

Preferably the consent is made in the written form

For the consent to be valid, the patient must understand to whom the info is disclosed, the purpose of disclosure, and the consequences that will follow

Certain relevant info must be disclosed to employers and insurance companies

Information is often shared with patient’s relatives or other persons helping to care for the patient

This may be without the patient’s authority, but is clearly for the patient’s best medical interest

Eg: disclosing to parents regarding their children’s condition

Clinical information is normally shared by medical practitioners involved with a particular patient, even without the patient’s express consent and on a ‘need to know’ basis.

The clinical team also has rights to access clinical notes made by their colleagues relating to the care of the patient.

Different priorities in law and medicine makes it difficult to resolve all the dilemmas which can rise from medical confidentiality

Patients do have rights to expect all information and records about their treatment is kept confidential by the physician and staff

Any information, such as test results, patient histories and even the fact that the patient is a patient cannot be told to other people.

A breach of confidentiality is both unethical and illegal