# UK Medical Law, Ethics & Public Health (UKMLA / PLAB 1): Mental Capacity Act 2005, Gillick Competence, DNACPR, DVLA Rules & Screening > Essential UK statutory medical law, GMC guidance, Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS), Gillick competence, Fraser guidelines, DVLA driving restrictions, and NHS population screening. - **Canonical URL:** https://flashcards.world/flashcards/sets/51ea514d-2858-4b3c-a1a0-fb57cfeaa4ec/ - **Markdown URL:** https://flashcards.world/flashcards/sets/51ea514d-2858-4b3c-a1a0-fb57cfeaa4ec.md - **Level:** basic - **Languages:** en → en - **Total Cards:** 32 ## Flashcards (32 Cards) | # | Front (Term / Prompt) | Back (Definition / Answer) | Example | Multiple-Choice Options | | :--- | :--- | :--- | :--- | :--- | | 1 | In epidemiological study design, why is a Case-Control study preferred over a Cohort study for rare diseases? | Case-control studies start by recruiting patients who already have the rare outcome (cases) and look retrospectively at exposures, calculating an Odds Ratio (OR) quickly without waiting decades. | | | | 2 | What must a doctor do if a patient with epilepsy or severe visual impairment refuses to stop driving despite clear advice? | Explain the legal duty, try to persuade the patient, offer a second opinion, and if they continue to drive, disclose relevant medical information directly to the DVLA in the public interest, informing the patient in writing. | | | | 3 | In biostatistics, if a randomized trial comparing Drug X to placebo has an Absolute Risk Reduction (ARR) of 4% (0.04), what is the Number Needed to Treat (NNT)? | NNT = 1 / ARR = 1 / 0.04 = 25 patients must be treated to prevent one adverse outcome. | | | | 4 | What are the 4 functional criteria required to demonstrate capacity under the Mental Capacity Act 2005? | 1) Understand the relevant information, 2) Retain that information long enough to decide, 3) Weigh or use the information as part of the process, and 4) Communicate the decision by any means. | | | | 5 | Can a Gillick-competent 15-year-old's refusal of life-saving treatment be overridden in England and Wales? | Yes—while Gillick-competent under-16s (and 16–17 year olds) can consent to treatment, their refusal of life-saving treatment can be overridden by the courts (or in exceptional cases parents) in their best interests. | | | | 6 | Under the MCA 2005, can a patient with capacity refuse life-saving treatment (e.g., blood transfusion or amputation) for an irrational reason? | Yes—an unwise or irrational decision does NOT mean a patient lacks capacity; a capacitous adult can refuse any treatment, even if refusal leads to death. | | | | 7 | What did the landmark UK Supreme Court case Montgomery v Lanarkshire Health Board (2015) establish regarding informed consent? | Doctors must disclose any 'material risk' to which a reasonable person in the patient's position would likely attach significance, replacing the paternalistic Bolam test for risk disclosure. | | | | 8 | What makes an Advance Decision to Refuse Treatment (ADRT) legally valid for refusing life-sustaining treatment in the UK? | It must be made by a capacitous adult (≥18), be in writing, signed and witnessed, and explicitly state that the refusal applies 'even if life is at risk'. | | | | 9 | When a patient lacks capacity and has no valid Advance Decision or Lasting Power of Attorney (Health & Welfare), when must an IMCA (Independent Mental Capacity Advocate) be instructed? | When serious medical treatment or long-term accommodation changes are proposed and the patient is 'unbefriended' (no family or friends appropriate to consult). | | | | 10 | What is the NHS Abdominal Aortic Aneurysm (AAA) screening schedule and action thresholds? | One-off ultrasound for all men at age 65: <3.0 cm = normal (discharged); 3.0–4.4 cm = annual ultrasound; 4.5–5.4 cm = 3-monthly ultrasound; ≥5.5 cm (or growing >1 cm/year) = urgent 2-week vascular surgery referral. | | | | 11 | When can a doctor breach patient confidentiality without consent due to a gunshot or knife wound in the UK? | Police must be notified immediately whenever a patient presents with a gunshot wound or a knife/sharp-instrument attack wound (excluding accidental or self-inflicted wounds), initially without patient identity if stable, or disclosing identity if public safety requires it. | | | | 12 | Can a Next of Kin consent to or refuse medical treatment on behalf of an adult who lacks capacity in the UK? | No—'Next of Kin' has no legal power to consent or refuse treatment unless they hold a registered Lasting Power of Attorney (LPA) for Health and Welfare or are a Court-Appointed Deputy. | | | | 13 | What type of bias occurs when hospital inpatients with chronic bronchitis are more closely questioned about smoking than healthy controls? | Recall bias (or interviewer/observer bias if the investigator probes cases more thoroughly than controls). | | | | 14 | According to DVLA Group 1 (car/motorcycle) guidelines, what is the driving restriction after a single unprovoked first seizure with normal neuroimaging and EEG? | Must stop driving immediately and inform the DVLA; may resume driving after 6 months seizure-free (12 months if structural abnormality or epileptiform activity on EEG). | | | | 15 | What is the NHS Bowel Cancer Screening Programme protocol? | Home Faecal Immunochemical Test (FIT) offered every 2 years to men and women aged 50–74 (expanding down from 60 to 50). | | | | 16 | Which infectious diseases are Notifiable Diseases to the UK Health Security Agency (UKHSA) based on clinical suspicion alone? | Measles, Mumps, Rubella, Meningococcal septicaemia, Acute meningitis, Tuberculosis, Cholera, Diphtheria, Food poisoning, Scarlet fever, Whooping cough, Malaria, and Tetanus (NOT HIV). | | | | 17 | When must a death be referred to HM Coroner in England and Wales? | When the cause of death is unknown, violent/unnatural, due to industrial disease/poisoning, occurred during state detention (prison/MHA section/DoLS), related to surgery/anaesthesia, or when no attending doctor saw the deceased appropriately. | | | | 18 | What is the legal difference between Ordinary and Extraordinary LPAs under the MCA 2005? | A Property and Financial Affairs LPA can be used while the donor still has capacity (if permitted), whereas a Health and Welfare LPA can ONLY be used once the donor lacks capacity for the specific decision. | | | | 19 | What is the DVLA Group 1 driving restriction after an established diagnosis of epilepsy or multiple seizures? | Must be seizure-free for at least 12 months before resuming Group 1 driving. | | | | 20 | What is the DVLA Group 1 driving restriction following Percutaneous Coronary Intervention (PCI / angioplasty) after an Acute Coronary Syndrome (ACS)? | Stop driving for 1 week after successful elective or urgent PCI (assuming LVEF ≥40% and no other disqualifying condition); if no successful PCI after MI, stop driving for 4 weeks. No need to notify DVLA for Group 1. | | | | 21 | What is the legal mechanism used in UK hospitals/care homes to lawfully deprive an incapacitous adult of their liberty in their best interests? | Deprivation of Liberty Safeguards (DoLS) transitioning to Liberty Protection Safeguards (LPS) under the Mental Capacity Act. | | | | 22 | What is Lead-Time Bias in cancer screening evaluation? | Apparent increase in survival time from diagnosis solely because screening detects the disease earlier in its natural history, without actually delaying the time of death. | | | | 23 | Under UK law (Tracey judgment), what is the legal requirement regarding a DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) decision? | While DNACPR is ultimately a clinical decision (a patient cannot demand CPR that is medically futile), there is a legal duty under Article 8 ECHR to consult and inform the patient (or family if lacking capacity) unless doing so would cause physical or psychological harm. | | | | 24 | What is the legal difference between Gillick Competence and the Fraser Guidelines? | Gillick competence assesses whether any child <16 has sufficient maturity and intelligence to consent to medical treatment generally; Fraser guidelines apply specifically to providing contraception/sexual health advice without parental knowledge. | | | | 25 | What is the statutory age below which a child is deemed legally incapable of consenting to sexual activity in the UK, requiring mandatory safeguarding consideration? | Under 13 years of age (sexual activity with a child under 13 is statutory rape and must always be discussed with safeguarding leads). | | | | 26 | What is the DVLA Group 1 driving rule after a single Transient Ischaemic Attack (TIA) or minor stroke with full recovery? | Must not drive for 1 month; no need to notify the DVLA unless there are residual neurological deficits after 1 month or multiple TIAs (which require 3 months off driving and DVLA notification). | | | | 27 | Under GMC guidance, how should a doctor respond when a patient requests access to their medical records? | Patients have a statutory right to access their health records under the Data Protection Act 2018 / UK GDPR free of charge within 1 month, redacting only third-party confidential info or details causing serious harm. | | | | 28 | Under the Abortion Act 1967 in Great Britain, what is the standard statutory gestational limit and signatory requirement? | Up to 24 weeks gestation, certified in good faith by two registered medical practitioners (except in an immediate life-saving emergency where one doctor suffices, or >24 weeks for severe fetal abnormality/grave permanent injury). | | | | 29 | What is the NHS Cervical Screening schedule using primary high-risk HPV testing? | Every 3 years for ages 25–49 and every 5 years for ages 50–64 (Actually updated in Wales/Scotland and transitioning in England: standard PLAB/UKMLA rule is 25–49 every 3 years, 50–64 every 5 years; if HPV negative, return to routine recall). | | | | 30 | What is the NHS Breast Screening Programme schedule? | Mammography every 3 years for women aged 50 to 70 (up to their 71st birthday). | | | | 31 | What is the first statutory principle of the Mental Capacity Act (MCA) 2005 in England and Wales? | A person must be assumed to have capacity unless it is established that they lack capacity (capacity is time-specific and decision-specific). | | | | 32 | What is the difference between Sensitivity and Specificity in diagnostic testing? | Sensitivity = TP / (TP + FN), measuring ability to rule OUT disease when negative (SnNOut); Specificity = TN / (TN + FP), measuring ability to rule IN disease when positive (SpPIn). | | | --- Study this deck interactively with FSRS-6 spaced repetition, audio review, and multiple-choice mode at [Flashcards World](https://flashcards.world/flashcards/sets/51ea514d-2858-4b3c-a1a0-fb57cfeaa4ec/).