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What if patient refuses to have chaperone present?

1I am a young male GP and one of our female patients says

various previous doctors have performed inappropriate intimate examinations on her. She frequently comes to me with minor gynaecological problems that require a pelvic examination. I suggested our practice nurse should act as a chaperone, but she won't have any other person present on any occasion. What should I do?

You would be unwise to examine this patient without a chaperone. It is also important that the chaperone has nothing to gain from misrepresenting the situation: her presence must provide protection for both you and the patient.

But you may not force any patient to have a chaperone present and if you try to force her to agree then her consent would not be legally valid. Your practice policy should require all partners to make appropriate use of a chaperone for intimate examinations and you should inform the patient of this.

If she refuses to accept a chaperone you should inform her that you would be unable to continue treating her. You could quite reasonably claim the professional relationship between the two of you had broken down and you could ask her to find a new GP.

She should contact the PCT for assistance if she is unable to find a new GP who is prepared to register her. You may ask the PCT to remove her from your list if necessary.

If you believe it is clinically vital that she is examined, there may be less risk if a female partner examines her. If this is not possible then you should seek the specific advice of your medical defence organisation before carrying out the examination yourself without a chaperone.

It would be very important to record the circumstances in which you performed the examination and any specific advice you had received. It would be wise to have one of your practice staff available outside the room in case the patient wishes to call for assistance.

Dr Christine Dewbury, Wessex LMCs

Neither Pulse nor Wessex LMCs can accept any legal liability in respect of the answers given. Readers should seek independent advice before acting on the information concerned.

Can we just change a name in the records?

2A mother recently came to the surgery and asked us to change her child's name on its medical records. Is this permissible? If a woman marries we change the name if we have seen a copy of the marriage certificate. What happens if an adult wishes to change their name for any other reason?

It is perfectly legal for anyone over 16 to use any name they choose, provided there is no intent to defraud anyone by using that new name. There is no formal legal process that has to be adopted.

The name on a birth certificate, marriage certificate or decree absolute cannot generally be changed.

To obtain official documents, like a passport or driving licence, or to amend current documents into the new name, will probably need legal evidence of the change. This may include:

·a letter from a responsible person

·a public announcement

·a statutory declaration

·a deed poll.

It is, however, not strictly essential to see the marriage certificate before changing the name on the medical records and the new name should simply be notified to the PPSA which will amend the records appropriately.

In the case of a name change for a child the situation is more complicated, unless the child has sufficient legal understanding to apply to the court personally for permission to change his or her name.

It is essential that a child between the ages of 16 and 18 signs a change-of-name deed as evidence of consent.

Dr Christine Dewbury, Wessex LMCs

Neither Pulse nor Wessex LMCs can accept any legal liability in respect of the answers given. Readers should seek independent advice before acting on the information concerned.

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