Examples of Duty of Care in Medical Practice
The duty of care in medical practice encompasses specific ethical and legal obligations that physicians must fulfill to protect patient welfare, minimize harm, and maintain professional standards. 1
Core Duty of Care Obligations
Primary responsibility to patient welfare - Physicians must embrace patient welfare as their primary professional responsibility, placing it ahead of their own interests and needs 2, 3
Competent clinical assessment - Physicians have a duty to make careful and competent assessments of patients through adequate history taking, careful clinical examination, appropriate investigations, and maintaining detailed clinical records 2
Providing best available care - Physicians must provide patients with the best care achievable with available resources, while recognizing when resources are too limited to provide safe care 2
Preventing foreseeable harm - Physicians have a duty to take steps to reduce foreseeable risks that patients might harm themselves or others, including warning patients about medical impairments that could affect activities like driving 2
Truthful communication - Physicians must communicate truthfully with patients and secure informed consent for treatment, unless the urgency of the patient's condition demands an immediate response 2
Patient Safety and Error Management
Reporting impaired colleagues - Physicians have an ethical obligation to report colleagues who practice under the influence of drugs or alcohol, have untreated mental health disorders, falsify medical information, or demonstrate intellectual dishonesty 2
Acknowledging medical errors - Physicians must be open about risks and variations in performance, communicate effectively about errors, and admit to errors that occur in judgment-based clinical decision-making 2
Reporting sentinel events - Physicians must report unexpected occurrences involving death, serious injury, or risk thereof to appropriate authorities such as hospital peer-review bodies or the Joint Commission 2
Maintaining professional competence - Physicians must engage in continuing education to maintain knowledge and skills necessary to provide high-quality care 2
Professional Conduct and Relationships
Non-discrimination - There must be no discrimination against patients for any reason 2
Honesty and integrity - Physicians must act fairly and honestly in all private and professional matters, never making false or misleading claims about qualifications, training, appointments, experience, or health 2
Financial integrity - Physicians must never allow financial self-interest to affect patient care, must declare any financial interests in services or equipment offered to patients, and should never accept incentives to use particular services or equipment 2
Collegial relationships - Physicians must maintain good relations with patients, relatives, medical colleagues, and paramedical specialists, while avoiding unjustified criticism of colleagues 2
Public Health Responsibilities
Reporting requirements - Physicians must follow legal requirements regarding reporting of certain conditions to protect public health, such as notifying authorities about high-risk drivers with conditions like severe sleep apnea 2
Disaster response - Emergency physicians have a duty to be prepared to assume crisis triage roles when necessary and allocate scarce resources during disasters 2
Public health promotion - Physicians should support societal efforts to improve public health and safety, reduce effects of injury and illness, and secure access to emergency and basic healthcare for all 2
Common Pitfalls in Duty of Care
Failure to document rationale - Not documenting the reasoning behind clinical decisions, especially when deviating from established guidelines, can create legal vulnerability 3
Practicing outside scope - Providing care beyond one's training and expertise can lead to harm and liability 3
Inadequate follow-up - Failure to arrange adequate follow-up or communicate test results as promised constitutes a breach of duty 2
Conflict of interest - Allowing personal or financial interests to influence clinical decisions compromises the duty of care 3
Ignoring resource limitations - Failing to recognize when resources are insufficient to provide safe care or not seeking better alternative services when available 2
By understanding and fulfilling these duties of care, medical practitioners can ensure they meet their ethical, legal, and professional obligations while providing optimal care to their patients.