- Context of unmanaged liabilities
- Enforceable obligations
- Obligation to not negate ME/CFS legal status
- Obligation to procure ME/CFS medical education
- Obligation to not mislead or evade diagnosis and to provide sufficient detail (FND, MUS, PPS, ‘dysregulation model’ and Long Covid examples)
- Obligation to not abuse power and authority
- Obligation to recognise ME/CFS patient housebound or carer status
- Tests of lawfulness
- Risks – compliance and operational
- Unlawful clinical judgement (examples)
- Expertise risk and reputational risk – medical and legal
- Illusion of legal authority vs medical law enforcement
- Knowledge-gap risk and audit trails (examples plus research-market inefficiencies)
- Freedom of Information Act risks – flawed clinical judgement, discrimination and education refusal
- Third party risk from preceding unlawful clinical judgement
- Liability, malpractice and indemnification
- Irrelevance of official edicts and officialised redistribution of liabilities to frontline balance sheets (vaccination and NICE guideline examples)
- Compromised indemnification, insurance cover nullification and liability for lost income
- Evaluating duties of care and unmanaged risk exposures
- Risk mitigation
- Version history
These compliance documents are live pre-released drafts that are specifically not structured for scientific audiences. Specific scientific referencing can be provided in consulting contexts, not limited to practice management, claims management, underwriting or litigation support for professionals or organisations.
Copyright and redistribution rights are governed by our terms of site usage. Communication of factual or typographical errata or other suggestions is welcome. This content was originally contained here (external link), has been split into separate compliance sections on our website and is in need of significant ongoing update.
A journalistic summary of these documents for lay audiences will soon be published.
Educational materials defined by legally demonstrable scientific consensus are of material legal consequence versus liability for clinical outcomes, breaches of duty of care and relevant statutory and policy discrimination frameworks discussed in this document. This lack of medical education is documented empirically, by the UK National Institute of Health and Clinical Excellence and addressed by the US National Academy of Medicine (formerly the Institute of Medicine). In practical terms and beyond the statutory implications, this results in a generalisable obligation to procure such ME/CFS education. This merely details a range of associated General Medical Council (GMC) and the Care Quality Commission (CQC) requirements that can be enforceable at Judicial Review.
It is empirically improbable that a clinician’s judgement regarding ME/CFS can be assumed safe, appropriate or lawful, thus requiring the generalisable obligation to procure compliant education
The scientific literature demonstrates that it is empirically improbable that a clinician does not hold contra-scientific views and assumptions versus ME/CFS. It is therefore empirically improbable that a clinician’s judgement regarding ME/CFS can be merely assumed to be safe or appropriate. It is thus empirically improbable that a medical professional whose patient has/may have ME/CFS can be safely assumed to be 1) engaging the patient lawfully without unnecessary risk generation or 2) compliant with all indemnity or insurance requirements, risking the nullification, dilution or complication of cover. This is in addition to the generation of PTSD resultant from unlawful medical encounters (a phenomenon in this field documented as caused by frontline belief systems and knowledge gaps).
Unlawful clinical judgement and administrative decision-making can occur in contexts that relate to ME/CFS and related post-viral disease in areas most commonly including:
- diagnosis and progression
- determination/withholding of treatment
- determination of eligibilities
- determination of purported irrelevance
- biases that affects communications or non-ME/CFS medical care
The repeated research consensus outlines both lack of knowledge and counterfactual misconceptions amongst both primary and secondary care medics, substantiating a threat to frontline balance sheets and their contracting parties. This lack of knowledge amongst medics is specifically documented in NICE’s own published documentation of December 2020, reflected in CDC communications and others’. The persistence of the contra-scientific belief systems and incentive structures are further evidenced by eminent medical media activity and state/self-regulatory medical organisations, both of which have promoted liability accumulation via unusually low scientific standards that perpetuate medical error. These unusual limits of the medical and therapeutic professions versus the scientific consensus outwith their professions, exacerbate the live statutory and policy risks detailed below.
Unlawful clinical judgement and harm have been habitualised, with liability generation implications and unusually demonstrable causation
This unnecessarily elevated and unmanaged risk profile thus commonly results in unlawful clinical judgement, with sufficient evidence of harm done, liability generation implications and unusually demonstrable causation. It is therefore optimal, for immediate and extended liability holders, that empirical corroboration of incorrect belief systems that are normalised amongst many clinicians leads neither to missteps nor malpractice – thus leading to a generalisable obligation to procure education.
As in many other professions, a practitioner cannot always be compelled to pursue specific CPD. Any clinician is thus free to exclude themselves from duties due to disproportionate risk of unlawful incident, stemming from insufficient relevant education necessary to perform those duties lawfully or compliantly.
Detailed and auditable records of educational activities and associated communications can address live discrimination and freedom of information risks
Practices should thus maintain a detailed record and auditable communication trail of:
- CPD completions
- educational resources acquired and maintained
- refusals to educate or be educated, with legally sustainable reasoning
- responses to patient communications that highlight educational shortcomings
Such records address live risks of substantiatable discrimination and targeted uses of freedom of information law outlined in this document – these can be exacerbated by unhelpful record keeping or records of incriminating failures to communicate factually and/or sufficiently. Moreover, it also allows frontline services to firewall risks to the organisation, by documenting where medics refuse time-efficient education in preference for continued unlawful practice (there can be questions regarding a practitioner’s mental health and capacity). Such litigation-aware best practice will already be in place in some organisations and required by some insurers, specifically or broadly (of which the second’s significant freedom to nullify insurance cover increases in probability with the issues highlighted in this document).