I trained to treat people. Turns out I also had to know the law.

The moment I realised medico-legal risk is real was when I was asked to act independently as an intern. This included being asked to have Acute Resuscitation Plan (ARP) discussions and update ARPs, consent for surgeries and complete forms to enact the Guardianship Act. Not being clear on what is legally within my scope of practice as an intern meant that I felt pressured multiple times by superiors to complete legal forms that I didn't have the authority to do.

Thankfully, after clarifying with our supervisors, these were all close calls, as once I clarified my scope of practice, I could stand up for myself when I was asked in the future. I think it surprised me how often it happens that interns are asked to do something they're not allowed to do and pressured to do it as if it's a laziness issue, not a legal one. The moral of the story is - know your scope of practice and stand up for yourself!

The real ‘click’ moment I had would have been in the setting of an elderly patient who had lost capacity for making decisions. During ward rounds, the patient presented cognitively well and stated that she wished her son to have control of her finances. On this first review, I was unaware the patient did not have capacity to make such decisions. I did not act on her request, as I read through documentation that established an existing government enduring power of attorney from many years ago, where her wishes had been documented, and various family members all had financial interests with her money. This was appropriately managed by the lovely social work team. But if someone were to have done so, this could have dire implications for the patient's finances.