Four festive dilemmas

Test your knowledge of how you'd respond to these festive dilemmas...

A festive drink with a former patient

A junior doctor working in trauma and orthopaedics called the MDU's advice line after a former patient had asked him out for a drink. The patient had recently been discharged from one of the wards he covered, but his only involvement with the patient's care had been on post-operative ward rounds when other doctors were always present.

The doctor was keen to accept the offer but didn't want to overstep the professional/patient boundary.

The MDU advised the doctor to consider how recently and for how long he was involved in the patient's care and whether the person was vulnerable at the time or now. He would need to be satisfied that there could be no perception that he was taking advantage of his position, or of a vulnerable person, in order to accept the offer.

Find out more about the guidance on appropriate relationships between patients and doctors.

Fit for a Santa run

A GP contacted the MDU as she had received a form to certify a patient fit for a Santa run. On review of the patient's notes, the GP could see that he was young, fit and healthy and she was inclined to sign the form, but still wanted advice on the medico-legal implications of doing so.

The MDU adviser explained that such requests are not NHS work and the GP was not obliged to sign the form.

However, if she wished to do so, she should be aware of GMC guidance saying all doctors must work within the limits of their competence, make clear the limits of their knowledge and make sure information in any document they sign is accurate.

In order to sign the form, the GP would need to understand the level of fitness required for the run. If a patient asks you to certify them fit for an activity that is outside your area of expertise, you should explain to the patient why you are unable to sign the form, and suggest they get an opinion from a suitably qualified doctor.

Find out more about working at a sports event.

A sheep in distress

An MDU medico-legal adviser took a call at three AM on Christmas Eve from a consultant obstetrician. The call was about her neighbour's heavily pregnant Dorset sheep. The sheep had suffered a large vaginal prolapse and the neighbour asked if the member would be willing to treat the sheep. The doctor didn't want to let down her neighbour but wanted to check that helping out was legal and ethical as she had no previous experience, professional or personal, in treating animals.

The GMC does not give specific advice on doctors treating animals. However, the Veterinary Surgeons Act 1966 only allows, in the majority of cases, qualified and registered vets to carry out veterinary surgery. This legislation also places restrictions on who can provide other treatment for animals.

Treating animals, even if the request comes from a vet, is not a matter where standard medical indemnity would usually apply.

Find out more about animals and medical indemnity.

Police want a sample from a party reveller

An ITU consultant contacted the MDU's advice line one evening to explain that two police officers were on the unit and had asked him to take a blood sample from a newly admitted patient. The patient was unconscious, and had suffered several injuries following a road traffic accident earlier that night when driving back from the office Christmas party.

The police had reason to believe the patient was over the safe alcohol limit to drive and therefore wanted a blood sample taken as soon as possible, which could later be tested with the patient's consent.

The adviser directed the member to guidance on this topic from the Faculty of Forensic & Legal Medicine, which states that such specimens can be taken for future testing in these circumstances so long as it would not prejudice the patient's care.

However, a forensic health care practitioner (FHCP) must be asked to obtain the sample. If none is available, another doctor can be asked but not if they have any responsibility for the care of the patient. This meant the member could not be requested to take the sample or delegate the task to a colleague.

While on the phone to the MDU, the consultant explained to the police officers that it would not adversely impact the patient's care to take the sample but that he couldn't take it. The officers approached an FHCP instead.

This guidance was correct at publication 10/12/2019. 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.

Dr Ellie Mein MDU medico-legal adviser

by Dr Ellie Mein Medico-legal adviser

MB ChB MRCOphth GDL LLM

Ellie joined the MDU as a medico-legal adviser in 2013. Prior to this she worked as an ophthalmologist before completing her Graduate Diploma in Law in Birmingham.

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