Roy G Beran
University of New South Wales, Australia
Scientific Tracks Abstracts: Health Syst Policy Res
This talk adopted a controversial title, to encourage reconsideration of the role of Guidelines, when practising medicine. Guidelines are developed by experts, in any given field, designed to advise others of the minimum standards which are expected of them. These minimum standards are developed so that those who are less familiar with what is expected, within the domain, to have a checklist of expectations that can help determine how best to perform, when dealing with problems relevant to that discipline. Guidelines offer parameters, serving as an acceptable set of rules, by which the legal system can adopt minimal standards, when considering the possibility of negligence within health care. The contents of the Guidelines are not the only parameter, by which acceptable standards can be judged. Within the Australian Common Law jurisdiction, there are additional legislative considerations, provided by the various Civil Liability Acts, of which there are equivalent Acts, in each Australian state, such as the Civil Liability Act 2002 No 22, as applicable in New South Wales (NSW). The NSW Civil Liability Act, section 5O, makes provision for consideration that what a clinician has delivered, as proper medical care, is not negligent if it conforms with that which a respected body of peers would have endorsed as proper care, in accordance with that which (s)he, or they, would have performed in similar circumstances, even if in contravention of any Guidelines, unless such activity would be considered irrational. Based on the condition that Guidelines provide aids to define acceptable practice, when a clinician has more detailed experience within the field, and that clinician can establish that others of similar experience, would practice in similar fashion, which may not conform to the Guidelines, then Guidelines appear as roadmaps for amateurs, rather than absolute criteria to establish minimum standards of patient care.
Professor Beran is a consultant neurologist with a long history of involvement in epilepsy related research. He has been on the executive of the Epilepsy Society of Australia, Commissions from the International League against Epilepsy and the International Bureau for Epilepsy.