We know that our members are using their best efforts to try and resolve problems raised by the lack of availability of appropriate PPE pragmatically, but some are worried they could be put in a position where they had to consider whether they could proceed with treatment because PPE that would provide them with an appropriate level of protection was not available.
We hope this sort of balancing decision will arise as a last resort, in circumstances where every other option has been either considered or is not available.
Members need to be aware of how the GMC has addressed this issue in their ethical hub where their guidance states that:
“We do not expect doctors to leave patients without treatment, but we also don’t expect them to provide care without regard to the risks to themselves or others. This pandemic is an unprecedented challenge in which clinicians are understandably balancing the imperative to provide care with their own fears.”
The GMC guidance goes on to address the question of whether doctors will face criticism if they refuse to treat a patient and states “If a concern was raised with us about a doctor refusing to treat a patient because of their concerns about inadequate PPE, we would need to look at the specifics and manner of that refusal, as we would with any other concern referred to us.”
The guidance then says that the doctor should be able to show that careful consideration was given to how the situation might be resolved and in particular:
- whether treatment can be delayed, or provided by another team
- what course of action is likely to result in the least harm in the circumstances
- whether alternative actions or additional steps can be taken to minimise the risk of transmission
- whether any doctors or other healthcare professionals are at a higher risk from infection than other colleagues.
In addition to considerations about your patients’ and your own health, you will also need to take into account that if you were to become infected it could also place other patients, colleagues and anyone else you come into contact with at risk of infection, and you will not be able to work.
It is essential to make a full record of how you have carefully considered all these points and of the efforts you have made to work with colleagues to provide the best care in the circumstances.
Clearly this is not a question with a black and white answer. MDU members who find themselves in such a situation and want to talk through their approach are encouraged to contact our 24 hour medico-legal helpline on 0800 716 646.
What do I do if I get complaints or GMC investigations about any aspect of my work during the Covid-19 outbreak?
It is possible for complaints and GMC referrals to be made during or as a result of this Covid-19 outbreak. The MDU is ready to assist in the usual way and it is important that members continue to seek our advice with any medico-legal problems as soon as they arise by contacting our freephone advisory helpline.
This guidance was correct at publication 27/04/2020. It is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.