Hot topic: Ebola advice for doctors

The Ebola outbreak in West Africa is taking on a more global dimension, with screening now being rolled out at major UK entry points, including Heathrow and the Eurostar terminal.

The overall risk to the public in the UK remains low, but the screening and treatment of those who may have contracted or been exposed to Ebola could present ethical challenges for doctors.

On this page we summarise our advice for doctors who are working in the UK.

UK-Med is coordinating volunteers from the NHS willing to support the UK’s response to Ebola in West Africa. The registration period will close on 31 October 2014 (although it may be extended, depending on need). Doctors who are interested in volunteering in West Africa can .

What advice do you have for doctors who may be asked to treat a patient who has, or may have, Ebola? 

In paragraph 58 of Medical practice we say:

You must not deny treatment to patients because their medical condition may put you at risk. If a patient poses a risk to your health or safety, you should take all available steps to minimise the risk before providing treatment or making other suitable alternative arrangements for providing treatment.

What this means in practice is that doctors have a duty to ensure that patients have access to appropriate care, but we do not expect doctors to provide care without regard to the risk to themselves or others.

In the case of infectious disease, doctors should take all available steps to ensure that they are suitably equipped (for example, with protective clothing) to minimise the risk of transmission before providing treatment.

Doctors must also ensure that their clinical judgements and assessments of risk (to themselves and others) are informed by up to date information from authoritative sources. Up to date guidance can be found on the following web pages:

You can also find Ebola top facts and mythbuster on the website.

Do doctors have to treat people with Ebola?

In paragraph 58 of Medical practice we say: ‘You must not deny treatment to patients because their medical condition may put you at risk.’

This means that doctors have a duty to ensure that patients have access to appropriate care, but we do not necessarily expect doctors to provide care personally. There may be reasonable and defensible reasons (such as the doctor’s own health placing them at increased risk of infection) for asking another suitably qualified clinician to take over the care of the patient.

What do doctors with management responsibilities need to do?

Doctors who are in management roles should ensure that staff have the necessary equipment and the right information to treat patients while minimising the risk to themselves.

Further advice on the management and leadership responsibilities of doctors is given in Leadership and management for all doctors.

What if doctors are concerned about the equipment and information available?

If a doctor is concerned about the risk to themselves - for example because of lack of information or equipment available - we advise that they discuss these issues at local level, with their employer or contracting body, in line with our guidance Raising and acting on concerns about patient safety.

Will we take action if a doctor refuses to treat a patient who has, or may have, Ebola?

Failure to follow our guidance does not automatically mean we will take action. This is because the guidance sets out the principles of good practice, not thresholds at which we think a doctor is safe to work.

The primary requirement for all doctors is to respond responsibly and reasonably to the circumstances they face.

If we receive a complaint, we will consider it on its merits, taking account of all the circumstances of the case.

I am a doctor in training and want to volunteer. Will this have an impact on my training?

Any absences from your training will need to be agreed in advance with your Postgraduate Dean. This may need to be approved via the Out of Programme system (see the (pdf) page 42) if you wish it to count towards your training. You may also wish to refer to the Communitybaptistpa position statement on time out of training (pdf). You will see from this position statement that absences do not necessarily lead to training being extended.

 

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