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Wednesday 18 April 2012

ETHICAL LEGITIMACY - The ethical practice of child psychologists in the U.K. - they now have the 'ethical legitimacy' to highlight the practice of medical colleagues who they feel are potentially causing harm to a client that they are involved with by challenging the over-prescription of psychotropic drugs due to their side effects. The key clause from the Health Professions Council (HPC) 'Duties of a Registrant' is: "You must not do anything or allow anything to be done that you have good reason to believe will put the health or safety of a patient, client or service user in danger."

The main responsibilities of health professionals -
You must always keep high standards of conduct.


1. You must act in the best interests of your patients, clients and users
You are personally responsible for making sure that you promote and protect the best interests of
the people you care for. You must respect and take account of these factors when providing care
and must not exploit or abuse the relationship with a patient, client, user or carer. You must not allow your views about patients’, clients’ or users’ sex, age, colour, race, disability, sexuality, social or economic status, lifestyle, culture or religious beliefs to affect the way you treat them or the professional advice you give.

You must, at all times, act to protect the interests of patients, clients, users, carers and other members of the public. 
You must try to provide the best possible care, either alone or with other health and social care professions. 
You must not do anything or allow anything to be done that you have good reason to believe will put the health or safety of a patient, client or user in danger.
This includes both your own actions and those of others.


When working in a team you are still responsible for your professional conduct, any care or professional advice you provide, any failure to act and for any tasks you ask someone else to carry out. You must act to protect patients if you believe they are threatened by a colleague’s conduct, performance or health. The safety of patients, clients and users must come first at all times and has to override any personal and professional loyalties. As soon as you become aware of any situation
which puts a patient, client or user at risk, you should discuss the matter with a senior professional colleague. If you feel you cannot raise the matter with a senior colleague, you can contact our Registrar.

2. You must respect the confidentiality of your patients, clients and users You must treat information about patients, clients or users as confidential and use it only for the purpose for which it was given. You must not knowingly release any personal or confidential information to anyone who is not entitled to it, and you should check that people who ask for information are entitled to it. You must only use information about a patient, client or user:
• to continue to care for that person; or
• for purposes where that person has given you specific permission to use the information.
You must also keep to the conditions of any relevant data protection legislation and follow best practice for handling confidential information relating to individuals at all times. Best practice is likely to change over time, and you must stay up to date. You must be particularly careful not to disclose, deliberately or accidentally, confidential information that is stored on computers.

3. You must keep high standards of personal conduct
You must keep high standards of personal conduct, as well as professional conduct. You must not do anything which may affect someone’s treatment by, or confidence in, you.
We can take action against you if you are convicted of a criminal offence or have accepted a police caution. But we will always consider each case on its merits and we will take decisions in the light of the circumstances of the case. However, as guidance, we will seriously consider rejecting an application for registration, or striking you off if you are already registered, and you are convicted of a criminal offence that involves one of the following types of behaviour:

• Violence
• Abuse
• Sexual misconduct
• Supplying drugs
• Drink-driving offences where someone was hurt or killed
• Serious offences involving dishonesty
• Any serious criminal offences which you received a prison sentence for
This is not a complete list. We will always look at any conviction or caution that we learn of, and we have arrangements in place to be told about cautions and convictions involving registrants.

4. You must provide any important information about conduct, competence or health
Normally, the police will contact us about people claiming to be members of our professions who
have been convicted or cautioned. Even so, you must also tell us (and other relevant regulators
and professional bodies) if you have any important information about your conduct or competence
or about other registrants and health professionals you work with. In particular, you must let us
know straight away if you are:
• convicted of a criminal offence (other than a minor motoring offences) or accept a police
• disciplined by any organisation responsible for regulating or licensing a health or social care
profession; or
• suspended or placed under a practice restriction by an employer or similar organisation because
of concerns about your conduct or competence.
You should co-operate with any investigation or formal inquiry into your professional conduct, that of any other healthcare provider or into the treatment of a patient, client or user, where
appropriate. If anyone asks, and they are entitled to it, you should give them any relevant information in connection with your conduct or competence.
You should also provide information about the conduct or competence of other healthcare providers, if you are asked for it by someone who is entitled to know. This is related to your duty to act in the best interests of your patients, clients and users, which was explained earlier in this document.
You should also tell us about any significant changes in your health, especially if you have changed your practice as a result of medical advice. We will keep this information private but it is vital that you tell us, and if you do not, we could take action against you.
You must always keep high standards of performance

5. You must keep your professional knowledge and skills up to date. You must make sure that your knowledge, skills and performance are of a high quality, up to date,
and relevant to your field of practice.
You must be capable of meeting our standards of proficiency, which relate to clinical practice.
You have to meet these standards, whether you are in clinical practice or not, and this includes managers, educators and researchers. However, it is important to recognise that the standards of proficiency are minimum standards of clinical practice. If you want to be on our register and use a
professional title, you must maintain your clinical standards so that you are able to practise the basic skills of your profession safely, even if this no longer forms the basis of your day-to-day
You must stay up to date with the changes to the standards of proficiency that we make for your profession as technology and techniques develop. We cannot and will not routinely test all
registrants to check that they are still meeting the standards of proficiency. However, we can and will test you if we have reason to believe that you might not meet the standards of proficiency any more.

6. You must act within the limits of your knowledge, skills and experience and, if necessary, refer on to another professional
You must keep within your scope of practice. This means that you should only practise in those fields in which you have appropriate education, training and experience.
When accepting a patient, client or user, you have a duty of care. This includes the obligation to refer them for further professional advice or treatment if it becomes clear that the  task at hand isbeyond your own scope of practice. A person is entitled to a referral for a second opinion at any time and you are under an obligation to accept the request and do so promptly. If you accept a referral from another health or social care professional, you must make sure that you fully
understand the request. You should only provide the treatment or advice if you believe this is appropriate. If this is not the case, before beginning any treatment you must discuss the matter with both the practitioner who has made the referral and also the patient, client or user.

7. You must maintain proper and effective communications with patients, clients, users,
carers and other professionals
You must take all reasonable steps to make sure that you can communicate properly and
effectively with your patients, clients and users, and their carers and family. You must also
communicate effectively, co-operate, and share your knowledge and expertise with professional
colleagues for the benefit of patients, clients and users.
8. You must effectively supervise tasks you have asked others to carry out for you
People who consult you or receive treatment or services from you are entitled to assume that their
treatment will be carried out by a person who has the knowledge and skill to practise their
profession. Whenever you give tasks to another person to carry out on your behalf, you must be
sure that they have the knowledge, skills and experience to carry out the task safely and
effectively. If they are not health professionals, you must not require them to do the work of health
professionals. If they are health professionals, you must not require them to do work that is
outside their scope of practice. If they are training to be health professionals, you should be sure
that they are capable of carrying out the task safely and effectively.
Whoever you ask to carry out a task, you must always continue to give adequate and appropriate
supervision and you will stay responsible for the outcome. If someone tells you that they are
unwilling to carry out a task because they do not think they are capable of doing so safely and
effectively, you must not force them to carry out the task anyway. If their refusal raises a
disciplinary or training issue, you must deal with that separately, but you should not endanger the
safety of the patient, client or user.
9. You must get informed consent to treatment (except in an emergency)
You must explain the treatment you are planning on carrying out, the risks involved and any other
treatments possible to the patient, client or user. You must make sure that you get their informed
consent to any treatment you do carry out. You must make a record of the person’s treatment
decisions and pass this on to all members of the health or social care team involved in their care.
In emergencies, you may not be able to explain treatment, obtain consent or pass on information
to other members of the health or social care team. However, you should still try to do all of these
things as far as you can.
If someone refuses treatment, and you believe that it is necessary for their well-being, you must
make reasonable efforts to persuade them, particularly if you think that there is a significant
and/or imminent risk to their life. You must keep to your employers’ procedures on consent and
be aware of any guidance issued by the Department of Health or other appropriate authority in the
country in which you practise.
10. You must keep accurate patient, client and user records
Making and keeping records is an essential part of care and you must keep records for everyone
you treat or who asks for professional advice or services. All records must be complete and
legible, and you should write all entries, sign and date them.
If you are supervising students, you should also sign any student’s entries to the notes. Whenever
you review the records, you should update them and include a record of any arrangements you
have made for the continuing care of the patient, client or user.
You must protect information in records against loss, damage or use by anyone who is not
authorised. You can use computer-based systems for keeping records, but only if they are
adequately protected against tampering by anyone (including other health professionals). If you
update a record, you must not erase information that was previously there, or make that
information illegible. You must instead mark it in some way (for instance, by drawing a line
through the outdated information).
11. You must deal fairly and safely with the risks of infection
You must not refuse to treat someone just because they have an infection. Also, you must keep to
the rules of confidentiality when dealing with people who have infections. For some infections,
such as sexually transmitted infections, these rules may be more restrictive than the rules of
confidentiality for people in other circumstances. Confidentiality was discussed in more detail
earlier in this document.
You must take appropriate precautions to protect your patients, clients and users, their carers and
families, your staff and yourself from infection and, in particular, you should protect your patients,
clients and users from infecting one another.
You must take precautions against the risks that you will infect someone else. This is especially
important if you suspect or know that you have an infection which could harm others, particularly
patients, clients and users. If you believe or know that you may have such an infection, you must
get medical advice and act on it. This may include the need for you to stop practising altogether,
or to change your practice in some way in the best interests of protecting your patients. Health
issues are discussed in more detail later in this document.
12. You must limit or stop practising if your performance or judgement is affected by your
You have a duty to take action if your health could be harming your fitness to practise. If you do
not take action, and your physical or mental health is harming your fitness to practise, we can take
action against you. The action that you should take is to get advice from a consultant in
occupational health or another suitably qualified medical practitioner and act on it. This advice
should consider whether, and in what ways, you should change your practice, including stopping
practising if this is necessary. You should also tell us about significant changes to your health and
any changes you make to your practice as a result.
You must always keep high standards of ethics
13. You must carry out your duties in a professional and ethical way
You must carry out your duties and responsibilities in a professional and ethical way. Patients,
clients and users are entitled to receive good and safe standards of practice and care. We intend to
protect the public from unprofessional and unethical behaviour and we aim to make sure that
health professionals are in absolutely no doubt about the standards we expect them to meet. These
standards are needed to protect the public and as a health professional, you have special
responsibilities that go beyond those expected of other people.
14. You must behave with integrity and honesty
You must make sure that you behave with integrity and honesty and keep to high standards of
personal and professional conduct at all times.
15. You must follow our guidelines for how you advertise your services
Any advertising you do in relation to your professional activities must be accurate. Any
advertisements must not be misleading, false, unfair or exaggerated. In particular, you should not
claim your personal skills, equipment or facilities are better than anyone else’s unless you can
prove that this is true.
If you are involved in advertising or promoting any product or service, you must make sure that
you use your scientific knowledge and clinical skills and experience in an accurate and
professionally responsible way. You must not make or support unjustifiable statements relating to
particular products. Any potential financial rewards to you should play no part at all in your
advice or recommendations of products and services to patients, clients and users.
16. You must not bring your profession into disrepute
You must not get involved in any behaviour or activity which is likely to bring your profession into disrepute.

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