Preface xiii
1 A Framework of Accountability for Nurses 1
Learning objectives 1
Introduction 1
A framework of accountability 2
The first pillar of accountability: professional accountability 4
The second pillar of accountability: ethical accountability 5
The third pillar of accountability: legal accountability 7
The fourth pillar of accountability: employment accountability 8
Conclusion 10
Useful websites 14
References 14
2 The First Pillar of Accountability: Professional Accountability 15
Learning objectives 15
Introduction 15
A classification of regulation in professional accountability 16
The function of regulation in professional accountability 18
Regulatory bodies for professional accountability 19
The Nursing and Midwifery Council 22
Other codes of conduct and guidance 27
The future of professional accountability 29
Useful websites 29
References 30
3 The Second Pillar of Accountability: Ethical Accountability 31
Learning objectives 31
Introduction 32
Autonomy 33
Paternalism 35
Utilitarianism 36
Equity 38
Best interests 39
Trust and truth 40
Acts and omissions 42
Application to accountability 44
Useful websites 44
References 45
4 The Third Pillar of Accountability: Legal Accountability 46
Learning objectives 46
Introduction 47
What is law? 48
Why is law important? 48
Where is law made? 50
How is law made? 51
Who are lawyers? 54
Types of law 55
European law and devolution in the UK 60
Application to accountability 61
Useful websites 62
References 62
5 The Fourth Pillar of Accountability: Employment Accountability 63
Learning objectives 63
Introduction 64
The employment relationship 64
Types of employment relationship 67
The contract of employment 69
Protocols and policies 70
Working Time Directive 71
Discrimination 71
Family rights 73
Unfair dismissal and redundancy 75
Health and safety 77
Application to accountability 78
Useful websites 79
References 79
6 Structures: The Health Service 81
Learning objectives 81
Introduction 81
The Health Service and devolution in the UK 82
Rights to treatment and resources 86
Quality standards 90
Application to accountability 94
Useful websites 95
References 95
7 Structures: Rights and Redress 97
Learning objectives 97
Introduction 97
Human rights 98
Redress in health care 103
Application to accountability 110
Useful websites 110
References 110
8 Concepts: Negligence 112
Learning objectives 112
Introduction 113
The first principle: duty of care 114
The second principle: breaking the duty of care 116
The third principle: causation 118
The fourth principle: compensation 119
Employers liability and indemnity insurance 121
Contributory negligence and time limits 122
Assault 123
Application to accountability 124
Useful website 125
References 125
9 Concepts: Consent 126
Learning objectives 126
Introduction 126
Why consent is important 127
The three principles of consent 130
Consent and young people 133
Consent and adults 136
Emergency treatment 138
Consent forms 139
Conclusion 139
Useful websites 140
References 140
10 Applications: Confidentiality 141
Learning objectives 141
Introduction 141
Legal accountability 143
Professional accountability 147
Ethical accountability 150
Employment accountability 152
Practical tips for protecting confidentiality in clinical relationships 154
Conclusion 155
Useful websites 155
References 155
11 Further Applications in Accountability 157
Learning objectives 157
Introduction 157
Abortion and conscientious objection 158
Scenario 159
Palliative care and gifts 164
Scenario 164
Conclusion 170
Useful websites 170
References 171
Index 173
