At 06:51 PM 12/3/98 EST, you wrote:
>In a message dated 12/3/98 11:35:05 GMT, you write:
>
><<
> A cardiac arrest is by definition an emergency and we are not and have
> never been an emergency service.
>
> I understand that an absolute refusal may perhaps bring your ToS around your
> neck. >>
>
>I know I'm being pedantic but I think there is confusion about a fact,
whether
>you would be in breach of your T.O.S and a judgement whether you would do any
>good anyway at the arrest. The two need to be separated and the question
>answered with reference to our T.O.S. Unless there is a more appropriate
>course of action agreed, you have to attend otherwise you would most
likely be
>in breach of your T.O.S.
>
>Jenny
This point is valid in general, though not sure it's relevant here.
Remember a GP being censured because of failure to attend an n th call for a
visit to a terminally ill patient. Had been before +++ and all acknowledged
that no more could be done. Judgement said something like family were
entitled
to expect the support of the GP at a time like this. Given multiple visits
already that day I remember being a bit horrified at the failure to leave us
any protection.
However as others have said referral to A&E without attendance does seem to
fulfill our ToS in the cardiac arrest situation. The John Wayne clause in our
ToS - a GPs gotta do what a GPs gotta do - is the reason why it's so important
that you get your LMC on side. They represent, for better or worse, the
reasonable standard of care in your patch.
Am I alone in being surprised by the number of people on this list, not
just now
but in respect of other circumstances eg. Bristol, who are willing to condemn
colleagues. Disagreeing, suggesting different ideas etc is one thing, but
I would want to be on pretty certain ground before suggesting to a
colleague that
they were in breach of ToS, or negligent or GMC fodder.
The days of cover ups are rightly over, but don't the MDU and GMC still
tell us
to make sure we have taken great care and made appropriate enquiries before
publicly criticising colleagues?
Julian
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