> It seems pretty clear from the papers cited earlier that
> PTSD as a
> result of not having witnessed a death is not reasonably foreseeable in a
> person of reasonable fortitude.
> Duty of care to others where that would involve a breach of
> confidentiality to the patient has a tighter test still- I'm not aware of
any UK case (but
> am pleased to be corrected) where such a duty was held to exist.
> There is always the possibility of a court extending the duty of care, but
> establish a new duty of care, a court must decide it be in the public
> interest to do so. I don't know if breach of patient confidentiality to
> prevent PTSD would be held in the public interest (as this would
> effectively establish a routine duty to breach confidentiality)
> This is a little bit irrelevant in any case: not having relatives
> present is
> an accepted standard of care by a reasonable body of medical opinion.
The question about the rights of parents is an interesting one, because
allowing parents into the resus room has become an "acceptable standard of
practice". At what age (of child or parent) do parents cease to be parents
and become "relatives"? Whose call is it?
I am not sure about the argument about breach of confidentiality in the
resus situation for the following reasons:
Hypothetical patient in RTA - A&B compromised; C needing support; GCS=8
(E2,V2,M4); has #tib/fib and femur.
Do you wait to get consent from patient to discuss injuries or prognosis
with relatives? Clearly in the abscence of knowledge of an Advanced
Directive, consent to next of kin is taken as implied in most cases. So,
why is a resus situation different?
I don't think that there are any hard and fast rules here, but our duty is
to ensure that we act act reasonably in all these situations.