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Medico-Legal Issues in Emergency Medicine and Family Practice


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Table of Contents

Foreword I
Foreword II
Foreword III
About the Authors

Case Scenarios
1 Drug overdose - Process of discharge against medical advice
2 Underage pregnancy - Concept of "Gillick competence" and patient
3 Self-harm - Concept of abscondment and "false imprisonment"
4 Drunken driving - When to legally do an alcohol level test
5 Drug abuse - Dilemma of reporting vs not reporting
6 Withholding of diagnosis from a patient - Is it legal?
7 Emergency procedure - Difficulty in obtaining informed consent
8 Non-accidental injury - Dilemma of refusal for admission
9 Withholding of life-support procedures - Concept of "Advance Medical Directive"
10 Turning away patients - Concept of vicarious liability
11 HIV - Infectious Disease Act; when to disclose information
12 Allergic reaction - Can ignorance be used as defence?
13 Intravenous potassium chloride death - Gaps in medical knowledge; censure
14 Informal medical consultation - Legal implications
15 Death from negligence; legal implications of a locum
16 Pre-hospital accidents - Legality to check a patient's belongings; reporting to the authorities
17 Research - Informed consent
18 Falsification of medical records vs good documentation
19 Defensive medicine - How to reduce the risk of being sued
20 Impending lawsuit - When to suspect it and how to prepare for it
21 Jehovah's Witness - Dilemma of refusal of blood transfusion
22 Plane doctor - Medical ethics on "not helping"
23 Voluntary medical practitioner - Bound by the same rules?
24 Human Organ Transplant Act (HOTA)
25 Refusal of a doctor to attend to a pre-hospital patient
26 Illegal prescription of controlled drugs - Legal implications
27 False accusation against a doctor
28 Patient's verbal abuse of doctor - What legal recourse does the doctor have?
29 Research - Waiver of informed consent
30 Death from aspiration - "Foreseeable" harm
31 Informed consent of the mentally subnormal individual
32 Non-adherence to duty of care - Legal recourse
33 Missed diagnosis of strabismus and exotropia and failure to refer to consultant ophthalmologist - GP practice
34 Failure to inform a patient of ocular side effects of steroids - Medical negligence in informed consent
35 Patient with a history of epilepsy - Should the doctor report?

Appendix 1 The Bolam case
Appendix 2 The Bolitho case
Appendix 3 The Chester v Afshar case
Appendix 4 The Road Traffic Act
Appendix 5 The Declaration of Helsinki
Appendix 6 The (US) Belmont Report 1979


About the Author

Catherine Tay is an associate professor lecturing law at the NUS Business School, National University of Singapore (NUS). She also supervises year 4 medical students at the Yong Loo Lin School of Medicine, NUS, in medico-legal and business issues in their electives. Prof Tay is an advocate and solicitor of the Supreme Court of Singapore, and a barrister-at-law (of Lincoln's Inn, United Kingdom). She is the author of 28 law books including a book on Medical Negligence. Shirley Ooi is Chief and Senior Consultant at the Emergency Medicine Department (EMD), National University Hospital and Clinical Associate Professor at the Yong Loo Lin School of Medicine, NUS. She is also an adjunct professor at the Department of Emergency Medicine, Universiti Kebangsaan Malaysia. Prof Ooi's passion is in teaching, including teaching of evidence-based medicine. She is also active in research, especially in emergency cardiac care.

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