Legal Issues for the Medical Practitioner

Contents......Page 6
About the author......Page 10
Disclaimer......Page 11
Preface......Page 12
List of Statutes......Page 14
List of Cases......Page 18
Introduction......Page 20
A - The Hong Kong Legal System......Page 22
1. The Hong Kong legal system – an overview......Page 24
B - Legal Issues......Page 32
I - Medical Practice......Page 34
2. What is fiduciary relationship?......Page 36
3. The professional duty of care......Page 38
4. What standard of care do doctors owe patients?......Page 41
5. Establishing a ‘doctor-patient relationship’ – the significance......Page 44
6. Delegation of duties......Page 46
7. Registration – the meaning......Page 48
8. What to include on your name card......Page 51
9. Notes in the charts as evidence of fact......Page 53
10. Your signature......Page 55
11. Alteration of medical records......Page 57
12. What to include in the medical notes......Page 59
13. The chaperone......Page 61
14. Treating friends and relatives......Page 63
15. Examining your colleague!......Page 65
16. Medical or professional insurance – is it necessary?......Page 67
17. Remote control medical orders......Page 69
18. Medical consultation – urgent......Page 72
19. Checking laboratory results......Page 73
20. Phoned laboratory reports......Page 75
21. Dress codes: skirt and tie......Page 76
22. Medical fees......Page 80
23. Rebate......Page 82
24. Restraining patients......Page 84
25. Discharge against medical advice......Page 86
26. Sick leave......Page 89
27. Absence of leave......Page 91
28. Off-duty working......Page 93
29. The diagnosis on sick leave certificates......Page 95
30. Sick leave or attendance certificate?......Page 97
31. Medical reports......Page 98
32. Sexual harassment......Page 100
33. Am I being harassed?......Page 102
34. Intimacy with patients or their relatives!......Page 106
35. Dishonesty......Page 109
36. Inadvertent dishonesty......Page 111
37. Abortion......Page 114
38. Drink driving......Page 116
39. Appearance in magazines......Page 118
40. Medical photography......Page 120
41. Videotaping gynaecological examinations......Page 122
42. Surveillance at work......Page 125
43. A bad reference......Page 129
44. I want to see Dr. X!......Page 131
45. Orders from your boss to which you disagree!......Page 132
46. Authorship in publications......Page 134
47. Unauthorised use of the hospital computer system......Page 136
48. Avoiding complaints......Page 138
49. Accepting gifts and presents......Page 142
50. Internet medical practice......Page 145
51. Distant medical technology......Page 149
II - Consent......Page 152
52. A valid consent......Page 154
53. Age for consent: Gillick competence......Page 158
54. Guardianship issues......Page 161
55. Emergency treatment and consent......Page 163
56. Is consent for treatment a contract?......Page 165
57. Incidental surgery......Page 167
58. Clinical studies and patient consent......Page 169
59. Patient withdrawal of consent......Page 171
III - Confidentiality......Page 172
60. Data protection and privacy......Page 174
61. Duty of confidentiality......Page 177
62. Medical records – ‘Hospital Property: Patients Not Allowed to Read’!......Page 180
63. Explaining a patient’s condition to the relatives......Page 182
64. The Personal Data (Privacy) Ordinance......Page 185
IV - Negligence and Liability......Page 188
65. What constitutes medical negligence?......Page 190
66. The Koo test......Page 192
67. Vicarious liability......Page 194
68. What besides simple negligence?......Page 196
69. To seek legal advice – is it necessary or advisable?......Page 198
70. No admission......Page 200
71. Causation of damage – proven?......Page 202
72. Relevance of the Limitation Ordinance......Page 207
73. The real significance of legal costs......Page 209
V - The Court and Attendance......Page 212
74. Court summons as a witness......Page 214
75. Court attendance – are you an expert?......Page 216
76. Cross-examination vs examination......Page 218
77. Entitlement to fees for court attendance by a doctor......Page 220
78. Writing expert opinions – charging, competence and liability......Page 222
79. Without prejudice and legal professional privilege......Page 225
80. Security for costs......Page 227
VI - The Medical Council......Page 230
81. The Medical Council or the court?......Page 232
82. Role of the Medical Council......Page 234
83. What offences would count?......Page 236
84. What constitutes ‘Professional Misconduct’?......Page 238
85. Colleagues practicing inappropriately......Page 240
VII - Death......Page 242
86. ‘Do Not Resuscitate’......Page 244
87. Substitute decision-making......Page 246
88. Euthanasia......Page 248
89. Quality of death......Page 251
90. Medical futility......Page 253
91. Clinical post-mortem or Coroner’s Court......Page 256
VIII- The Profession and Society......Page 258
92. To whom am I responsible?......Page 260
93. Moral duty versus legal duty......Page 262
94. Good practice versus legal requirement......Page 264
95. Accidents on the road......Page 266
96. Tied hand and foot......Page 269
97. Managed care......Page 270
98. General approach in decision-making in ethical issues......Page 272
99. Professionalism......Page 274
100. A health service ombudsman?......Page 278
Afterword......Page 280
An approach to problem solving......Page 282
Glossary......Page 284
List of Reference Materials......Page 292
Index......Page 298