Duty of care

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The duty of care of a doctor in a jurisdiction may be defined legally in some countries. It tends to be most severely tested at times of exposure to a health crisis that threatens the health of the doctor[1]. Nurses and medical students may have different duties of care to a doctor, and duty of care of others involved in health care, such as porters or healthcare managers will be even more divorced from a doctor's duty of care.

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The GMC guidance is that as a doctor "make the care of your patient your first concern". Thus once a person becomes your patient a duty of care exists that outweighs all your other duties of care as far as the GMC is concerned. This may be inconsistent with other potential duties of care that a doctor may have[2]. With regard to NHS care, the NHS constitution does give some rights but perhaps the most relevant is that NHS patients have the right to drugs and treatments that have been recommended by NICE for use in the NHS, if your doctor says they are clinically appropriate for you. A commissioning or providing organisation has no similar duty of care to a regulator, as a first priority, indeed their first priority is not to exceed the resources granted to them to provide healthcare.

Legally general duty of care has not been defined as to when it comes into existence. However once a healthcare patient relationship has been accepted, a duty of care would exist as defined by Barnett v Chelsea and Kensington Hospital Management Committee [1969] with a responsibility that exists even if the doctor is ill themselves.

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see Coleman CH, Reis A. Potential penalties for health care professionals who refuse to work during a pandemic. JAMA : the journal of the American Medical Association. 2008 Mar 26; 299(12):1471-3.(Link to article – subscription may be required.)
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see Davies CE, Shaul RZ. Physicians' legal duty of care and legal right to refuse to work during a pandemic. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne. 2009 Dec 14.(Epub ahead of print) (Link to article – subscription may be required.)

This article is a work in progress. Please feel free to contribute to it.


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