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Bolam V Friern Hospital Management Committee
''Bolam v Friern Hospital Management Committee'' 9571 WLR 582 is an English tort law case that lays down the typical rule for assessing the appropriate standard of reasonable care in negligence cases involving skilled professionals such as doctors. This rule is known as the Bolam test, and states that if a doctor reaches the standard of a responsible body of medical opinion, they are not negligent. ''Bolam'' was rejected in the 2015 Supreme Court decision of ''Montgomery v Lanarkshire Health Board'' in matters of informed consent. Facts Mr Bolam was a voluntary patient at Friern Hospital, a mental health institution run by the Friern Hospital Management Committee. He agreed to undergo electro-convulsive therapy. He was not given any muscle relaxant, and his body was not restrained during the procedure. He flailed about violently before the procedure was stopped, and he suffered some serious injuries, including fractures of the acetabula. He sued the committee for compensati ...
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Reasonable Care
In tort law, a duty of care is a legal obligation that is imposed on an individual, requiring adherence to a standard of reasonable care to avoid careless acts that could foreseeably harm others, and lead to claim in negligence. It is the first element that must be established to proceed with an action in negligence. The claimant must be able to show a duty of care imposed by law that the defendant has breached. In turn, breaching a duty may subject an individual to liability. The duty of care may be imposed ''by operation of law'' between individuals who have no ''current'' direct relationship (familial or contractual or otherwise) but eventually become related in some manner, as defined by common law (meaning case law). Duty of care may be considered a formalisation of the social contract, the established and implicit responsibilities held by individuals/entities towards others within society. It is not a requirement that a duty of care be defined by law, though it will oft ...
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Informed Consent
Informed consent is an applied ethics principle that a person must have sufficient information and understanding before making decisions about accepting risk. Pertinent information may include risks and benefits of treatments, alternative treatments, the patient's role in treatment, and their Right to refuse medical treatment, right to refuse treatment. In most systems, healthcare providers have a legal and ethical responsibility to ensure that a patient's consent is informed. This principle applies more broadly than healthcare intervention, for example to conduct research, to disclose a person's medical information, or to participate in high risk sporting and recreational activities. Within the United States, definitions of informed consent vary, and the standard required is generally determined by the state. As of 2016, nearly half of the states adopted a reasonable patient standard, in which the informed consent process is viewed from the patient's perspective. These standards ...
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Carcinoma
Carcinoma is a malignancy that develops from epithelial cells. Specifically, a carcinoma is a cancer that begins in a tissue that lines the inner or outer surfaces of the body, and that arises from cells originating in the endodermal, mesodermal or ectodermal germ layer during embryogenesis. Carcinomas occur when the DNA of a cell is damaged or altered and the cell begins to grow uncontrollably and becomes malignant. It is from the (itself derived from meaning ''crab''). Classification As of 2004, no simple and comprehensive classification system has been devised and accepted within the scientific community. Traditionally, however, malignancies have generally been classified into various types using a combination of criteria, including: The cell type from which they start; specifically: * Epithelial cells ⇨ carcinoma * Non-hematopoietic mesenchymal cells ⇨ sarcoma * Hematopoietic cells ** Bone marrow–derived cells that normally mature in the bloodstream ⇨ leuke ...
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Hodgkin's Disease
Hodgkin lymphoma (HL) is a type of lymphoma in which cancer originates from a specific type of white blood cell called lymphocytes, where multinucleated Reed–Sternberg cells (RS cells) are present in the lymph nodes. The condition was named after the English physician Thomas Hodgkin, who first described it in 1832. Symptoms may include fever, night sweats, and weight loss. Often, non-painful enlarged lymph nodes occur in the neck, under the arm, or in the groin. Persons affected may feel tired or be itchy. The two major types of Hodgkin lymphoma are classic Hodgkin lymphoma and nodular lymphocyte-predominant Hodgkin lymphoma. About half of cases of Hodgkin lymphoma are due to Epstein–Barr virus (EBV) and these are generally the classic form. Other risk factors include a family history of the condition and having HIV/AIDS. Diagnosis is conducted by confirming the presence of cancer and identifying Reed–Sternberg cells in lymph node biopsies. The virus-positive cases are ...
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Tuberculosis
Tuberculosis (TB), also known colloquially as the "white death", or historically as consumption, is a contagious disease usually caused by ''Mycobacterium tuberculosis'' (MTB) bacteria. Tuberculosis generally affects the lungs, but it can also affect other parts of the body. Most infections show no symptoms, in which case it is known as inactive or latent tuberculosis. A small proportion of latent infections progress to active disease that, if left untreated, can be fatal. Typical symptoms of active TB are chronic cough with hemoptysis, blood-containing sputum, mucus, fever, night sweats, and weight loss. Infection of other organs can cause a wide range of symptoms. Tuberculosis is Human-to-human transmission, spread from one person to the next Airborne disease, through the air when people who have active TB in their lungs cough, spit, speak, or sneeze. People with latent TB do not spread the disease. A latent infection is more likely to become active in those with weakened I ...
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Maynard V West Midlands Regional Health Authority
''Maynard v West Midlands Regional Health Authority'' is an English tort law case concerning the Bolam test for professional negligence. The patient presented with symptoms of tuberculosis but both the consultant physician and the consultant surgeon took the view that Hodgkin's disease, carcinoma, and sarcoidosis were also possibilities, the first of which if present would have required remedial steps to be taken in its early stages. Instead of waiting for the results of the sputum tests, the consultants carried out a mediastinoscopy to get a biopsy. The inherent risk of damage was to the left laryngeal recurrent nerve, even if the operation was properly done. In the event, only tuberculosis was confirmed. Unfortunately, the risk became a reality and the patient suffered a paralysis of the left vocal cord. The decision of the physician and the surgeon to proceed was said by their expert peers to be reasonable in all the circumstances. The trial judge initially held that the surgeo ...
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Neck
The neck is the part of the body in many vertebrates that connects the head to the torso. It supports the weight of the head and protects the nerves that transmit sensory and motor information between the brain and the rest of the body. Additionally, the neck is highly flexible, allowing the head to turn and move in all directions. Anatomically, the human neck is divided into four compartments: vertebral, visceral, and two vascular compartments. Within these compartments, the neck houses the cervical vertebrae, the cervical portion of the spinal cord, upper parts of the respiratory and digestive tracts, endocrine glands, nerves, arteries⁣⁣ and veins. The muscles of the neck, which are separate from the compartments, form the boundaries of the neck triangles. In anatomy, the neck is also referred to as the or . However, when the term ''cervix'' is used alone, it often refers to the uterine cervix, the neck of the ⁣⁣uterus⁣⁣. Therefore, the adjective ''cervical'' ...
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Sidaway V Bethlem Royal Hospital Governors
''Sidaway v Board of Governors of the Bethlem Royal Hospital'' 985UKHL 1 is an important House of Lords case in English tort law, specifically medical negligence, concerning the duty of a surgeon to inform a patient of the risks before undergoing an operation. It has largely been overturned by ''Montgomery v Lanarkshire Health Board'', which determined that there is a duty on doctors to take reasonable care to ensure that a patient is aware of material risks inherent in treatment. Facts The claimant suffered from pain in her neck, right shoulder, and arms. Her neurosurgeon took her consent for cervical cord decompression, but did not include in his explanation the fact that in less than 1% of the cases, the said decompression caused paraplegia. She developed paraplegia after the spinal operation. Judgment Rejecting her claim for damages, the court held that consent did not require an elaborate explanation of remote side effects. In dissent, Lord Scarman said that the Bolam test ...
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Forceps
Forceps (: forceps or considered a plural noun without a singular, often a pair of forceps; the Latin plural ''forcipes'' is no longer recorded in most dictionaries) are a handheld, hinged instrument used for grasping and holding objects. Forceps are used when fingers are too large to grasp small objects or when many objects need to be held at one time while the hands are used to perform a task. The term "forceps" is used almost exclusively in the fields of biology and medicine. Outside biology and medicine, people usually refer to forceps as tweezers, tongs, pliers, clips or clamps. Mechanically, forceps employ the principle of the lever to grasp and apply pressure. Depending on their function, basic surgical forceps can be categorized into the following groups: # Non-disposable forceps. They should withstand various kinds of physical and chemical effects of body fluids, secretions, cleaning agents, and sterilization methods. # Disposable forceps. They are usually made of lo ...
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Childbirth
Childbirth, also known as labour, parturition and delivery, is the completion of pregnancy, where one or more Fetus, fetuses exits the Womb, internal environment of the mother via vaginal delivery or caesarean section and becomes a newborn to the world. In 2019, there were about 140.11 million human births globally. In Developed country, developed countries, most deliveries occur in hospitals, while in Developing country, developing countries most are home births. The most common childbirth method worldwide is vaginal delivery. It involves four stages of labour: the cervical effacement, shortening and Cervical dilation, opening of the cervix during the first stage, descent and birth of the baby during the second, the delivery of the placenta during the third, and the recovery of the mother and infant during the fourth stage, which is referred to as the Postpartum period, postpartum. The first stage is characterised by abdominal cramping or also back pain in the case of B ...
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Pregnancy
Pregnancy is the time during which one or more offspring gestation, gestates inside a woman's uterus. A multiple birth, multiple pregnancy involves more than one offspring, such as with twins. Conception (biology), Conception usually occurs following sexual intercourse, vaginal intercourse, but can also occur through assisted reproductive technology procedures. A pregnancy may end in a Live birth (human), live birth, a miscarriage, an Abortion#Induced, induced abortion, or a stillbirth. Childbirth typically occurs around 40 weeks from the start of the Menstruation#Onset and frequency, last menstrual period (LMP), a span known as the Gestational age (obstetrics), ''gestational age''; this is just over nine months. Counting by Human fertilization#Fertilization age, ''fertilization age'', the length is about 38 weeks. Implantation (embryology), Implantation occurs on average 8–9 days after Human fertilization, fertilization. An ''embryo'' is the term for the deve ...
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Specialist Registrar
A specialty registrar (StR), previously known as and still commonly referred to as a specialist registrar (SpR), is a doctor, public health practitioner or dentist who is working as part of a specialty training programme in the UK. This is known as a training grade as these doctors are supervised to an extent, as part of a structured training experience that leads to being able to undertake independent practice in a hospital specialty or working as a general practitioner. This training grade was introduced into UK postgraduate medical training in 2007 as part of the Modernising Medical Careers programme with the specialty registrar training places being created instead of the Senior House Officer (SHO) and Specialist registrar (SpR) posts. Background In the UK medical system, a specialist is someone who has the necessary experience and qualifications to be placed on the GMC's Specialist Register. Only persons on the Specialist Register can be appointed consultants in the Nation ...
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