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1.
Br J Nurs ; 30(3): 196-197, 2021 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-33565936

RESUMO

Richard Griffith, Senior Lecturer in Health Law at Swansea University, discusses recent cases from the Court of Protection that have focused on a person's mental capacity to engage safely with social media.

2.
Br J Nurs ; 30(1): 78-79, 2021 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-33433288

RESUMO

Richard Griffith, Senior Lecturer in Health Law at Swansea University, discusses the positive obligation to protect vulnerable people from unauthorised deprivations of liberty in various community settings.

3.
BMC Med Inform Decis Mak ; 21(1): 30, 2021 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-33509169

RESUMO

BACKGROUND: Informed consent is required for participation in clinical trials, however trials involving adults who lack capacity to consent require different enrolment processes. A family member usually acts as a proxy to make a decision based on the patient's 'presumed will', but these decisions can be challenging and families may experience an emotional and decisional burden. Decisions made on behalf of others are conceptually different from those made for ourselves. Innovations have been developed to improve informed consent processes for research, including a number of decision aids, however there are no interventions for proxies who are faced with more complex decisions. This article outlines the development of a novel decision aid to support families making decisions about research participation on behalf of an adult who lacks capacity to consent. METHODS: Decision support interventions should be developed using rigorous and evidence-based methods. This intervention was developed using MRC guidance for the development of complex interventions, and a conceptual framework for the development and evaluation of decision aids for people considering taking part in a clinical trial. The intervention was informed by a systematic review and analysis of existing information provision. Previous qualitative research with families who acted as proxies enabled the development of a theoretical framework to underpin the intervention. The intervention was iteratively developed with the involvement of lay advisors and relevant stakeholders. RESULTS: Previous research, theoretical frameworks, and decision aid development frameworks were used to identify and develop the intervention components. The decision aid includes information about the proxy's role and utilises a values clarification exercise and decision support methods to enable a more informed and better-quality decision. Stakeholders, including those representing implementers and receivers of the intervention, contributed to the design and comprehensibility of the decision aid to ensure that it would be acceptable for use. CONCLUSIONS: Frameworks for the development of decision aids for people considering participating in a clinical trial can be used to develop interventions for family members acting as proxy decision-makers. The decision support tool is acceptable to users. Feasibility testing and outcome measure development is required prior to any evaluation of its effectiveness.

4.
Br J Nurs ; 29(21): 1296-1297, 2020 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-33242275

RESUMO

Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers the role of the nearest relative, a statutory friend, appointed for patients detained under the Mental Health Act 1983.

5.
Br J Nurs ; 29(19): 1136-1137, 2020 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-33104423

RESUMO

Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers cases that highlight the consequences for nurses and their employer of failing to discharge their professional and statutory duty of candour.

6.
J Med Ethics ; 2020 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-32878918

RESUMO

Research involving adults who lack capacity to consent relies on proxy (or surrogate) decision making. Proxy decisions about participation are ethically complex, with a disparity between normative accounts and empirical evidence. Concerns about the accuracy of proxies' decisions arise, in part, from the lack of an ethical framework which takes account of the complex and morally pluralistic world in which proxy decisions are situated. This qualitative study explored the experiences of family members who have acted as a research proxy in order to develop an understanding of the ethical concepts involved, and the interactions between those concepts. Proxies described a complex process of respecting the wishes and preferences of the person they represented, whist integrating preferences with what they viewed as being in the interests of the person. They aimed to make a decision that was 'best' for the person and protected them from harm; they also aimed to make the 'right' decision, viewed as being authentic to the person's values and life. Decisions were underpinned by the relationship between the person and their proxy, in which both trust and trustworthiness were key. Proxies' decisions, based both on respect for the person and the need to protect their interests, arose out of their dual role as both proxy and carer. The findings raise questions about accounts which rely on existing normative assumptions with a focus on accuracy and discrepancy, and which fail to take account of the requirement for proxies to make authentic decisions that arise out of their caring obligations.

7.
Br J Nurs ; 29(17): 1042-1043, 2020 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-32972233

RESUMO

Richard Griffith, Senior Lecturer in Health Law at Swansea University, discusses the lawfulness of instructions to issue bulk do not attempt resuscitation orders during the COVID19 pandemic.


Assuntos
Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Ordens quanto à Conduta (Ética Médica)/legislação & jurisprudência , Humanos , Legislação de Enfermagem , Medicina Estatal/legislação & jurisprudência , Reino Unido/epidemiologia
8.
Br J Nurs ; 29(15): 908-909, 2020 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-32790552

RESUMO

Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers the law on decision-making capacity and recent approaches to the assessment of fluctuating capacity by the Court of Protection.

9.
Br J Nurs ; 29(13): 794-795, 2020 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-32649256

RESUMO

Richard Griffith, Senior Lecturer in Health Law at Swansea University, discusses the holding powers available under the Mental Health Act 1983 and why their use is prone to error.

10.
Br J Nurs ; 29(11): 642-643, 2020 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-32516046
11.
Br J Nurs ; 29(9): 537-538, 2020 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-32407224

RESUMO

Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers arrangements for indemnifying nurses returning to practice in the pandemic, and whether nurses might be given immunity from negligence claims.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/enfermagem , Imperícia/legislação & jurisprudência , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/enfermagem , Medicina Estatal/legislação & jurisprudência , Humanos , Seguro , Papel do Profissional de Enfermagem , Reino Unido/epidemiologia
12.
Br J Nurs ; 29(7): 446-447, 2020 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-32279550

RESUMO

Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers the legal definition of death and the law relating to the disposal of a body after death.


Assuntos
Morte , Legislação como Assunto , Planejamento Antecipado de Cuidados/organização & administração , Humanos , Relações Enfermeiro-Paciente , Reino Unido
13.
Br J Nurs ; 29(5): 326-327, 2020 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-32167816

RESUMO

Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers what powers are available to ministers, health and local authorities to minimise the spread of the novel coronavirus and the disease it causes.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pneumonia Viral/prevenção & controle , Saúde Pública/legislação & jurisprudência , Betacoronavirus , Infecções por Coronavirus/transmissão , Humanos , Pneumonia Viral/transmissão , Medicina Estatal , Reino Unido
14.
Geriatrics (Basel) ; 5(1)2020 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-32092854

RESUMO

Dysphagia is common-not only associated with stroke, dementia, Parkinson's but also in many non-neurological medical problems-and is increasingly prevalent in ageing patients, where malnutrition is common and pneumonia is frequently the main cause of death. To improve the care of people with dysphagia (PWD) and minimise risk of aspiration and choking, the textures of food and drinks are frequently modified. Whilst medicines are usually concurrently prescribed for PWD, their texture is frequently not considered and therefore any minimisation of risk with respect to food and drink may be being negated when such medicines are administered. Furthermore, evidence is starting to emerge that mixing thickeners with medicines can, in certain circumstances, significantly affect drug bioavailability and therefore amending the texture of a medicine may not be straightforward. Research across a number of hospital trusts demonstrated that PWD are three times more likely to experience medication administration errors than those without dysphagia located on the same ward. Errors more commonly seen in PWD were missed doses, wrong formulation and wrong preparation through medicines alteration. Researchers also found that the same patient with dysphagia would be given their medicines in entirely different ways depending on the person administering the medicine. The alteration of medicines prior to administration has potential for patient harm, particularly if the medicine has been designed to release medicines at a pre-defined rate or within a pre-defined location. Alteration of medicines can have significant legal implications and these are frequently overlooked. Dispersing, crushing or mixing medicines can be part of, or misconstrued as, covert administration, thus introducing a further raft of legislation. Guidance within the UK recommends that following identification of dysphagia, the ongoing need for the medicine should be considered, as should the most appropriate route and formulation, with medicines alteration used as a last resort. The patient should be at the centre of any decision making. Evidence suggests that in the UK this guidance is not being followed. This article considers the clinical and legal issues surrounding administration of medicines to PWD from a UK perspective and debates whether medicines optimisation should be the primary responsibility of the prescriber when initiating therapy on the ward or the nurse who administers the medicine.

15.
Br J Nurs ; 29(3): 176-177, 2020 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-32053442

RESUMO

Richard Griffith, Senior Lecturer in Health Law at Swansea University, discusses the circumstances that give rise to a duty of care and the standard expected of nurses in discharging their duty.


Assuntos
Legislação de Enfermagem , Imperícia/legislação & jurisprudência , Humanos , Reino Unido
16.
Br J Nurs ; 29(1): 66-69, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31917941

RESUMO

Richard Griffith, Senior Lecturer in Health Law at Swansea University, discusses the revised framework for authorising the deprivation of liberty of a person who lacks capacity.


Assuntos
Competência Mental/legislação & jurisprudência , Padrões de Prática em Enfermagem/legislação & jurisprudência , Humanos , Reino Unido
18.
Br J Nurs ; 28(19): 1268-1269, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31680574

RESUMO

Richard Griffith, Senior Lecturer in Health Law at Swansea University, outlines what constitutes fraud and the measures taken by the NHS to counter fraudulent activity.


Assuntos
Fraude/estatística & dados numéricos , Medicina Estatal , Fraude/legislação & jurisprudência , Humanos , Reino Unido
19.
Br J Nurs ; 28(21): 1428-1429, 2019 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-31778326

RESUMO

Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers the provisions of the Assaults on Emergency Workers (Offences) Act 2018.


Assuntos
Relações Enfermeiro-Paciente , Violência no Trabalho/legislação & jurisprudência , Serviços Médicos de Emergência , Humanos , Medicina Estatal , Inquéritos e Questionários , Reino Unido , Violência no Trabalho/estatística & dados numéricos
20.
Dementia (London) ; : 1471301219884426, 2019 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-31653184

RESUMO

People living with dementia may experience difficulties when making decisions for themselves in the later stages of the condition. While there are mechanisms in England and Wales for appointing an attorney to make decisions about welfare and finances on their behalf, there are no provisions for appointing an attorney to make future decisions about research participation. This is despite a growing focus on Advanced Care Planning and other processes that provide opportunities to discuss future preferences and ensure that decisions are made in line with those preferences. This qualitative study with 15 family caregivers who had acted as research proxies explored the role of Power of Attorney in their decisions about research, and their views about extending current legal arrangements to include research. Five themes were identified: the holistic nature of decision-making; the 'power' of attorney; making decisions by putting yourself in their shoes; support for bringing research under the umbrella of attorney arrangements and a unifying theme of trusting relationships. Legal provisions for prospectively appointing a research proxy may encourage discussion about future wishes and so enable decisions about research to be made that are in accordance with the person's preferences and wishes. However, further consultation with the public including people living with dementia and their families, and a range of stakeholders is needed. Providing guidance to families, people living with dementia and the wider research community may provide greater clarity and improve decision-making in the meantime.

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