Hook line and sinker: Legal and ethical issues in diabetes care

The rise in diagnosed cases of type 2 diabetes is well documented with the World Health Organisation (WHO 2013) stating that 347 million people world-wide have diabetes: they predict that by 2030 it will be the 7th most prevalent cause of death. Within England the Health Survey (HSCIC 2012) showed the prevalence of diabetes was 9.1% in men and 6.8% in women, up from 6.8% and 5.5% respectively in 2003. Quite apart from the human cost of mortality and morbidity, the cost of prescriptions for diabetes accounted for 9.3% of the total spend on drugs in England 2012-13 (HICSC 2013) representing and year on year rise.

In response practitioners across the board in primary and secondary care are charged with working together to manage patient care effectively. By uniting to address a common problem the potential for innovation in professional practice is opened and boundaries between professions are blurred. In addition, the diagnosis and treatment of type 2 diabetes and its related complications is a competitive multi–million pound international business, for which practitioners are often the decision makers when choosing and deploying resources. Against such a backdrop, this paper aims to explore the legal and ethical challenges faced and where the limits or 'edges' of responsibility and scope of practice lie.