Nursing Law and Ethics

`This process gives health professionals the opportunit yto set their own stan-

dards of professional practice, conduct and discipline. To justif ythis freedom

and maintain the trust of patients and their families, the professions are

required to be accountable in an open manner for the standards the yset and the

wa yin which these are enforced.' [25]

Continuing professional development and lifelong learning is seen in the White
PaperAFirst Class Serviceto be an essential component of clinical governance and
awa yof setting and monitoring standards. These could be positive moves in giving
the professions clear standards and the appropriate training to meet them.

11.15 Conclusion

Clinical governance can be seen as a positive move b ythe Government to ensure
that both Trusts and individual practitioners are more accountable and are held to
be responsible for the qualit yof the care the ydeliver. However, although qualit yof
health care provision is something we all want, the term `quality' is very hard to
define. Once it is recognised that questions of what we should be doing have
important ethical dimensions, then these ethical and value judgements can be
debated. Where possible value judgements can be formulated b ygeneral agree-
ment, and at the same time these debates can allow those who use the service to
have a sa yin what kind of NHS the ywish to see.

11.16 Notes and references

1. Goodman, N. ,1998) Clinical governance.BMJ,317, 1725±7.


2. Secretar yof State for Health ,1998)Afirst class service ,quality in the new NHS.NHS
   Executive, Leeds.


3. Campbell, A. ,1999) Clinical governance: the ethical challenge to medical education,
   Medical Education,33, 870±71.


4. Cooperet al.,1996) Pulmonar yarter ycatheters in the criticall yill: An overview of using
   the methodolog yof EBM.Critical Care Clinician, 12 ,4), 777±94.


5. Klein, R., Day, P. & Redmayne, S. ,1996)Managing Scarcity: Priority setting and rationing
   in the NHS.Open Universit yPress, Buckingham.


6. Rosenberg & Donald ,1995) Evidence based medicine: an approach to clinical problem
   solving.BMJ,310, 1122±6.


7. Muir Gray, J. ,1997)Evidence-based Health Care: how to make health policy and man-
   agement decisions.Churchill Livingstone, London.


8. Maynard, A. ,1997) Evidence-based medicine: an incomplete method for informing
   treatment choices.The Lancet,349, 126±8.


9. NICE ,2000) Appraisal of Beta Interferon and Glatiramer for the treatment of Multiple
   Sclerosis. Press Release, issued 21 June 08:30, ref. NICE 2000/020.


10. NHS Executive ,1996)Promoting clinical effectiveness.The Stationer yOffice, London.


11. Secretar yof State for Health ,1997)The new NHS ,modern ,dependable.The Stationery
    Office, London.


12. Hopkins & Solomon ,1996) Can contacts drive clinical care?BMJ,313, 477±8.


13. Suppes, P. ,1979) The logic of clinical judgement: Bayesian and other approaches. In

250 Nursing Law and Ethics