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Serious professional misconduct arising out of dental anaesthesia and sedation.

This paper reviews three recent decisions of the Judicial Committee of the Privy Council on appeal from decisions of the Professional Conduct Committee of the General Dental Council, in which questions of general anaesthesia, sedation and resuscitation were raised. The recommendations of the Poswillo Report on general anaesthesia, sedation and resuscitation in dentistry of March 1990 are considered with respect to these three cases, and an assessment made as to whether or not the incidents which gave rise to them would have occurred had the recommendations been implemented. The implications of the Poswillo Report for the maintenance of professional standards of conduct by the General Dental Council in relation to the use of general anaesthesia, sedation and resuscitation are discussed.

Anesthesia, Dental

A pilot study of medical student 'abuse'. Student perceptions of mistreatment and misconduct in medical school.

A pilot survey of one third-year medical school class was carried out to explore student perceptions of mistreatment and professional misconduct in medical school training. Students were asked to rate the frequency and cite sources of mistreatment and misconduct among classmates, faculty, residents, and interns. They were also asked to assess the effects of such episodes on their physical health, emotional well-being, social and family life, and attitudes toward becoming a physician. The results indicate that students perceive mistreatment (particularly verbal abuse and unfair tactics) to be pervasive and professional misconduct all too common. As many as three fourths of the students report having become more cynical about academic life and the medical profession as a result of these episodes. Two thirds feel they are worse off than their peers in other professions. More than a third have considered dropping out of medical school and one fourth report they would have chosen a different profession had they known in advance about the extent of mistreatment they would experience. Rather than dismiss these problems as isolated events, we need to examine this issue more closely.

Adult

Medical students' perceptions of cheating.

In 1985, 683 students at a large private upper-midwestern medical school were surveyed concerning the appropriateness of traditional cheating behaviors and behaviors related to professional misconduct and dishonesty in patient care. They also rated the acceptability of various rationalizations for these behaviors. The students agreed that traditional forms of academic cheating are inappropriate, but they did not agree about the appropriateness of certain behaviors in the areas of patient care and professional misconduct.

Crime

The General Medical Council: frame of reference or arbiter of morals?

Many members of the public think of the General Medical Council (GMC) as the body which tries doctors: the doctors' law courts, as it were. And, except in the more sober of newspapers and news reports, the 'offences ' which receive the most publicity are those concerning alleged improper relations between doctors and patients. Professor Sir Denis Hill, in the following paper, which he read in the spring of this year to the annual conference of the London Medical Group devoted to a discussion of human sexuality, chose to examine the whole function of the General Medical Council as a frame of moral reference for doctors. Judging allegations of professional misconduct by doctors is the function of the Council's Disciplinary Committee. Judging sexual misconduct forms only a small part of their work. The GMC's responsibility covers the whole notion of morals and morality as it concerns doctors in their professional work. Sir Denis Hill stresses the modern thinking that morality must be learned and that attitudes are always shifting as society alters its norms of what is moral conduct. That is not to say that all that was previously considered not to be moral has now become acceptable but rather that other concepts have entered the field of moral debate. Therefore the GMC must constantly review the frame of reference it offers to doctors and the public may be surprised to learn that that process is never static. Sir Denis Hill in this paper is speaking personally and not as a member of the General Medical Council or of any of that body's special committees.

Ethics, Medical

[Patients' complaints--many channels and poor oversight].

Patients' complaints in Norway about personal injury or professional misconduct may either be handled locally, or pass through one of two channels: the administrative channel or the legal channel for claims for damages. At present we are in a phase of transition, with a tendency to shift from settling cases in courts of law, which requires proof of professional negligence for damage award, to an official insurance system of compensation based on objective evidence. The administrative channel handles cases of alleged misconduct or malpractice. Allocation of cases to one or the other channel is somewhat haphazard. Comparing our system with the Swedish one, I make a plea for reassessment.

Insurance Claim Reporting

Professional medical discipline: an overview.

The new, current process of professional medical discipline in New York State is effective but cumbersome. The complexities associated with defining and proving professional misconduct together with the necessary due process provisions of the current law result in a time consuming process. There is room for improvement. It is clearly in the interests of the medical profession to have a strong, visible, viable, and effective program of professional medical discipline.

Certification

Professional ethics and patients' rights: past realities, future imperatives.

The nature and application of professional ethics in relation to patients' rights is not always clearly understood by healthcare professionals. As a result, patients' rights are not always respected or upheld in a way that they ought to be. An undersirable consequence of this has been that patients have suffered otherwise avoidable harms. The issue of professional ethics and patients' rights is one of concern to all healthcare professionals. It is of particular concern to nurses since they are the ones who are often caught in situations involving abuses of patients' rights. This paper briefly examines the failure of professional ethics to prevent patients' rights' abuses in healthcare contexts. It also makes recommendations on how the nursing profession could respond to this problem.

Altruism

Principles of ethics and code of professional conduct with official advisory opinions revised to May 1992.

The ethical statements which have historically been subscribed to by the dental profession have had the benefit of the patient as their primary goal. Recognition of this goal, and of the education and training of a dentist, has resulted in society affording to the profession the privilege and obligation of self-government. The Association calls upon members of the profession to be caring and fair in their contact with patients. Although the structure of society may change, the overriding obligation of the dentist will always remain the duty to provide quality care in a competent and timely manner. All members must protect and preserve the high standards of oral health care provided to the public by the profession. They must strive to improve the care delivered--through education, training, research and, most of all, adherence to a stringent code of ethics, structured to meet the needs of the patient.

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