Chapter 47 Emergency department administration, legal matters and quality care
HOW THE LAW AFFECTS THE PRACTICE OF EMERGENCY MEDICINE
Confidentiality
Some occasions arise where there is no absolute answer to the problem; for example, if a patient who is known to be involved in drug trafficking presents to the emergency department. In such a case, where doubt may exist, the advice of colleagues, medical administration and, even better, the advice of a medical defence organisation should be sought in order to assist the doctor to make the very serious decision as to whether to override the duty of confidentiality.
For guidance, the St Vincent’s Hospital policy regarding internally concealed drugs is shown in Box 47.1.
These patients may present of their own accord or may be brought in by the police.
(Reproduced with permission.)
∗ Under the Public Health Act 1991 and Regulation, hospital CEOs (or their delegates) are required to notify the following diseases to the local public health unit.
More legal obligations
How do you avoid a law suit?
In a study, the most common reasons given for beginning a malpractice suit against a doctor were:
Consent
There has been a change in the legal definition of informed consent following the Rogers v Whittaker decision. Courts now believe that, in giving informed consent, a patient must be informed of all material risks. A risk becomes ‘material’ if the judge believes that a reasonable person in the patient’s position would be likely to attach significant importance to it in deciding whether or not to have treatment.