Ebola epidemic: medicolegal issues for volunteer doctors
Authors: Marika Davies
Publication date: 31 Dec 2014
Marika Davies answers medicolegal questions about volunteering as a doctor to tackle the current outbreak of Ebola virus disease in west Africa
Can I ask my medical defence organisation for help for the work I do abroad? Do I have to arrange additional protection?
If you are planning to work as a volunteer abroad it is vital that you have appropriate protection in place. Non-government organisations and charities may provide cover for medical negligence claims, but you are unlikely to be protected for professional risks, such as General Medical Council (GMC) investigations. You should contact your medical defence organisation before travelling with the dates and details of the work you intend to do. They can advise whether you are in the correct category of membership and paying the appropriate subscription so that you can seek help should an incident arise.
What if I’m asked to participate in a trial of new drugs on the local population?
You should apply the same legal and ethical principles that you would in practice in the United Kingdom. You remain accountable to the GMC wherever you work and should be familiar with, and follow, its guidance on research. The GMC says, “You must use your judgment in applying the principles in the guidance to the types of research you undertake, and to the situations you face in practice as a doctor.” The importance of consent must not be forgotten. You must be satisfied that you have consent or other valid authority before you provide treatment or involve patients or volunteers in research.
Am I legally responsible for giving people an unlicensed drug?
You are responsible for any prescription you sign. If it is necessary to prescribe an unlicensed medicine to meet the specific needs of a patient, you must be satisfied that there is sufficient evidence or experience of using the medicine to demonstrate its safety and efficacy. You must also provide patients with enough information on which to make an informed decision. Make sure you document the reasons for prescribing an unlicensed medicine and ensure there are suitable arrangements in place for follow-up treatment of the patient. The GMC sets out guidance on prescribing unlicensed medicines with which you should be familiar if prescribing in this way.
What if I make an error while treating patients?
Any error that occurs should be managed in the same way as in your usual practice. Be open and honest with the patient, provide a prompt explanation and apology, inform a senior colleague or your employer, initiate appropriate systems reviews to see what lessons can be learnt, and write a report while the incident is fresh in your mind. Always keep clear, accurate, and legible medical records, which will be invaluable in explaining your actions should anything go wrong.
Competing interests: I have read and understood BMJ policy on declaration of interests and have no relevant interests to declare.
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Marika Davies medicolegal adviser
Medical Protection Society