Good Medical Practice in Paediatrics and Child Health

eing honest with the parents, confine the explanation to the areas of his or her ownexpertise.• Parents should be helped to ensure full and fair discussion takes place. Doctors have aresponsibility to take all appropriate steps to assure themselves and the family of thetruth of a situation.23. If a child has died you must explain, to the best of your knowledge, the reasons for,and the circumstances of, the death to those with parental responsibility. Similarly, if anadult patient has died, you should provide this information to the patient’s partner, closerelative or a friend who has been involved in the care of the patient, unless you havereason to believe that the patient would have objected.• The importance of obtaining an autopsy should be recognised. When seeking consentfor an autopsy on a child or a baby an experienced paediatrician should undertake thisdiscussion with the parents, in line with national guidance.• Teaching and experience in discussing the autopsy procedure and obtaining consentshould be given to all trainee paediatricians.• The autopsy itself should be carried out by an experienced paediatric or perinatal pathologist.Unacceptable practice:• Failure to listen appropriately to patients or carers or over-riding of any contrary viewswithout adequate reason or explanation• Failure to acknowledge an adverse incident or clinical error, if you believe one has occurred.• Failure to offer an apology on behalf of your team, if a member has been at fault• Knowingly to provide a misleading account of events• Discouraging further investigation of an adverse incident contrary to the interests of thefamily• Failure to take reasonable steps to ascertain the correct details• Failure to take reasonable steps to identify or knowingly to fail to disclose an event that mayhave significantly contributed to a deathEnding professional relationships with patientsGood Medical Practice - May 200224. Rarely, there may be circumstances, for example where a patient has been violentto you or a colleague, has stolen from the premises, or has persistently acted inconsideratelyor unreasonably, in which the trust between you and the partner has been broken and youfind it necessary to end a professional relationship with a patient. In such circumstances,you must be satisfied your decision is fair and does not contravene the guidance in paragraph6; you must be prepared to justify your decision if called on to do so. You should not endrelationships with patients solely because they have made a complaint about you or yourteam, or because of the financial impact of their care or treatment on your practice.25. You should inform the patient, orally or in writing, why you have decided to endthe professional relationship. You must also take steps to ensure that arrangements aremade quickly for the continuing care of the patient, and hand over records to the patient’snew doctor as soon as possible.• Paediatricians may be forced to end a professional relationship with a family. They areunder the same obligation to act fairly and to ensure the continuing care of the patient.17