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    Question:

    Should drunk and disorderly patients brought into A&E pay for their own medical treatment as opposed to the tax-payer?
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    (Original post by CasualSoul)
    Could a well informed/capacitated 15 year old refuse treatment (if parents wanted them to get it) due to autonomy or since they are a still considered a minor they would have to get the treatment f their parents wanted them to?
    I think that as they're still considered a minor the court could overrule the decision if there is risk of serious harm or death (Is this correct?), but I'm not too sure how that would work out to be honest, if the child is refusing, would he will be sedated and treated on? :confused:

    (Original post by DrumChops)
    Question:

    Should drunk and disorderly patients brought into A&E pay for their own medical treatment as opposed to the tax-payer?

    I think that as they have been brought into A&E the problem must be an emergency and they should be treated as soon as possible. If we start to charge drunk and disorderly patients it may seem we are charging for 'self inflicting' which could cover other conditions such as lung cancer from smoking or heart disease from obesity, this could lead to a slippery slope where we would have to pay for self inflicted diseases. This could be very problematic because if people have to pay for e.g. cancer treatment due to smoking they may not even visit the doctor for treatment if they cannot afford it, this could then lead to further problems later in life where the cancer may be more serious causing other complications - whether these complications could be classed as self inflicted or not would be another matter, and this could lead to further costs. All in all I would say it may be better, in the long run, just to treat them and give them advice.
    Another argument is taking up bed spaces in A&E but that probably isn't completely related.


    Are these arguments okay? Trying to get better at these ethical questions so need to practise as much as possible!
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    I remember reading this article around June time and feeling a bit sick:

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    (Original post by Secret.)
    I think that as they're still considered a minor the parents could be allowed to consent for them as long as it's in their best interests(Is this correct?), but I'm not too sure how that would work out to be honest, if the child is refusing I seriously doubt he will be sedated and treated on :confused:
    These kinds of cases are always quite complex; I think that this was brought up recently in a story where a 15 year old girl refused the MMR vaccination although her father wanted her to have it, and in such a case the court overruled the girl's wishes and ordered her to be vaccinated. However, the girl didn't appear as being well-informed enough. Usually, however, if the child is well-informed enough/shows capacity, the patient's autonomy is respected and they can consent for themselves (in spite of parents wishes). Then again it might depend on the kind of treatment - in the case of the MMR vaccine, not treating would not only affect the patient but have consequences for those around her. Someone can sharpen/correct me if I'm wrong.

    (Original post by Secret.)
    I think that as they have been brought into A&E the problem must be an emergency and they should be treated as soon as possible. If we start to charge drunk and disorderly patients it may seem we are charging for 'self inflicting' which could cover other conditions such as lung cancer from smoking or heart disease from obesity, this could lead to a slippery slope where we would have to pay for self inflicted diseases. This could be very problematic as if people have to pay for e.g. cancer treatment due to smoking they may not even visit the doctor for treatment if they cannot afford it, this could then lead to further problems later in life where the cancer may be more serious causing other complications - whether these complications could be classed as self inflicted or not would be another matter, and this could lead to further costs. All in all I would say it may be better, in the long run, just to treat them and give them advice.
    Another argument is taking up bed spaces in A&E but that probably isn't completely related.
    Good points overall. Slippery slope argument is a particularly good point. Being drunk and disorderly could point to imply conditions like alcoholism, and it seems unethical to fine patients for such cases because that is tantamount to getting a patient with an alcoholism induced liver condition to pay for their treatment; as you've said this could lead to the possibility of avoiding treatment to avoid paying for it.

    Other arguments are abusing and wasting the time of services such as ambulances, and police, hospital beds as you've said, as a result of something avoidable. It may also work as a form of prevention for over-drinking which could ultimately lead to alcoholism and later liver cancers etc.
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    (Original post by DrumChops)
    Question:

    Should drunk and disorderly patients brought into A&E pay for their own medical treatment as opposed to the tax-payer?

    I think this could be a good idea, as it might encourage more people to drink responsibly benefiting their health in the long run, whilst also reducing pressure in A&E and raising money the NHS could invest in the department.This seems especially important if you consider the demographic of drunk and disorderly patients, which is typically young, students or patients from deprived, working class backgrounds. Middle class profession drinkers tend to drink lots more indoors (according to some research i read somewhere) which means the people who would be charged are among the poorest in the population and this can act as deterrent to their drinking habits.

    On the other hand, it might put some lives in danger i.e. someone refusing immediate medical attention whilst dehydrated and retching in the middle of street because they will be charged money they can't afford later.

    So overall, I'm against charging drunk and disorderly patients.
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    (Original post by DrumChops)
    Question:

    Should drunk and disorderly patients brought into A&E pay for their own medical treatment as opposed to the tax-payer?
    The NHS is one of the few health organisations that do not discriminate on the basis of patients who abuse their own health. In my personal opinion, they should not be liable to pay for their own medical treatment. Their background or life circumstance is not known to us. We simply can not judge a patient by his or her initial façade. There may be more to what meets the eye. Perhaps his drinking problem may have been due to domestic abuse, or aggressive behaviour which the medical staff may not have been aware of. We can not sort patients into categories dependant on their actions, as some predicaments may have an obvious clear layer, but we, as doctors, can not see beyond those "layers". We should not stereotype patients and refuse them treatment due to the element of assumption. Perhaps the patient may not be aware of his disorderly demeanour due to psychological reasons. We can not neglect those patients and separate them from the rest. They need our attention as much as others do, and it is vital that we treat them equally. The notion of drunk patients needing to pay for their care may even discourage them from visiting the hospital and this may cause even more damage to them.

    Yes, a counterargument may be that it will save the A&E service considerable amounts of money, especially with the current financial struggle it is experiencing. Yes, the British public may take more responsibility for their actions if this new bill was to be introduced, leading to a reduction of patients that visit A&E. However, the NHS always had a philosophical core which makes it one of the greatest healthcare services in the world. It values the notion of free healthcare for all.
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    (Original post by frogs r everywhere)
    The NHS is one of the few health organisations that do not discriminate on the basis of patients who abuse their own health. In my personal opinion, they should not be liable to pay for their own medical treatment. Their background or life circumstance is not known to us. We simply can not judge a patient by his or her initial façade. There may be more to what meets the eye. Perhaps his drinking problem may have been due to domestic abuse, or aggressive behaviour which the medical staff may not have been aware of. We can not sort patients into categories dependant on their actions, as some predicaments may have an obvious clear layer, but we, as doctors, can not see beyond those "layers". We should not stereotype patients and refuse them treatment due to the element of assumption. Perhaps the patient may not be aware of his disorderly demeanour due to psychological reasons. We can not neglect those patients and separate them from the rest. They need our attention as much as others do, and it is vital that we treat them equally. The notion of drunk patients needing to pay for their care may even discourage them from visiting the hospital and this may cause even more damage to them.

    Yes, a counterargument may be that it will save the A&E service considerable amounts of money, especially with the current financial struggle it is experiencing. Yes, the British public may take more responsibility for their actions if this new bill was to be introduced, leading to a reduction of patients that visit A&E. However, the NHS always had a philosophical core which makes it one of the greatest healthcare services in the world. It values the notion of free healthcare for all.
    Great answer, fully agree, thanks for that enlightenment
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    Hey guys! I have an interview from Birmingham on the 22nd, but I have not revised? Is there still time to read about medicine?
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    (Original post by solarplexus)
    Hey guys! I have an interview from Birmingham on the 22nd, but I have not revised? Is there still time to read about medicine?
    No time at all, it's too late :rolleyes:
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    (Original post by FlavaFavourFruit)
    No time at all, it's too late :rolleyes:
    damnnnnnnnnnnnnnnnnnnn
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    Is anyone else's Track down??


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    (Original post by DrumChops)
    Question:

    Should drunk and disorderly patients brought into A&E pay for their own medical treatment as opposed to the tax-payer?
    I hate to be the spoilsport (again), but D&D patients wouldn't be brought into A&E...

    D&D is a non-recordable offence, so someone arrested for it would not remain in custody in hospital. If they needed hospital treatment the. They would simply be released, potentially with a fine...

    Drunk and incapable (D&I) prisoners would be brought into hospital. There is no point charging most of them for devices, as the majority would be alcoholics anyway with all the issues that brings. Plus, I've known quite a few D&I medical students in my time ;-)


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    (Original post by Pittawithcheese)
    I hate to be the spoilsport (again), but D&D patients wouldn't be brought into A&E...

    Posted from TSR Mobile

    I think this question is more about the issue of the classic Friday/Saturday night binge drinkers who clog up A&E departments i.e. being 'drunk and disorderly' describes their behaviour not the legality of their actions.
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    (Original post by knitted-unicorn)
    I think this question is more about the issue of the classic Friday/Saturday night binge drinkers who clog up A&E departments i.e. being 'drunk and disorderly' describes their behaviour not the legality of their actions.
    Ah, the "nighttime economy" you mean?

    As a copper, I expect my threshold for what constitutes disorderly behaviour is higher than most....


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    (Original post by Username97)
    There's no hope for the rest of us lol


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    Well it's a good sign at least I didn't get rejected from Cardiff yet lmao.

    Guys, how are UKCAT scores sent again? 'cus I didn't putan UCAS number or anything on the form.
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    (Original post by solarplexus)
    Hey guys! I have an interview from Birmingham on the 22nd, but I have not revised? Is there still time to read about medicine?
    I feel ya, I have an interview at Durham 20th. Feeling woefully underprepared. I'd recommend the isc medical book
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    (Original post by RadioheadAnton)
    I feel ya, I have an interview at Durham 20th. Feeling woefully underprepared. I'd recommend the isc medical book
    How much do we need to know on NHS reforms?

    I just read up on the health and social care act 2012. Are there any other reforms that we need to know about?
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    TSR Support Team
    (Original post by thefiretailedpony)
    Well it's a good sign at least I didn't get rejected from Cardiff yet lmao.

    Guys, how are UKCAT scores sent again? 'cus I didn't putan UCAS number or anything on the form.
    Pearson view send them off next month and match with the name and date of birth you supplied

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    (Original post by solarplexus)
    Hey guys! I have an interview from Birmingham on the 22nd, but I have not revised? Is there still time to read about medicine?
    You have THREE WEEKS! :rolleyes: Calm down.
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    (Original post by FlavaFavourFruit)
    Although I see benefits for GP surgeries opening 12 hours a day, 7 days a week allowing more patients to be seen thus relieving the pressure on A&E departments, I don't think it's practical. It won't be a quick fix.

    If this is going to work, I suggest replacing GP surgeries with large drop in centres where there are more doctors and nurses who will be able to see more patients in a day.
    Also, if you increase GP hours, you can't expect the same number of GPs to work 7 days a week, that's ridiculous and they have family too. There needs to be more recruitment of doctors (perhaps abroad as it's quicker than training docs in uk which takes a lot of time) plus locum docs are expensive
    However docs from abroad have to have a good understanding of english and good training as well as know our uk ethics as GPs are usually first point of contact.
    Also, from my work experience shadowing a GP, some GPs arrive way before 9AM and don't leave until 6-7PM, plus some GPs work out of hours and do home visits too

    I fear if GP surgeries open 24/7, some GPs might get ill due to overload of stress and they may emigrate.
    I have no idea how you would fund it tbh, i guess cuts from another service?

    some really good points are made there :yy:
 
 
 
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