• AMA with Certified Student Loan Professional

    Join SDN on December 7th at 6:00 PM Eastern as we host Andrew Paulson of StudentLoanAdvice.com for an AMA webinar. He'll be answering your questions about how to best manage your student loans. Register now!

Ethics Question

Southpaw

Full Member
Lifetime Donor
15+ Year Member
Aug 12, 2004
2,429
4,191
  1. Attending Physician
    I had a practice question about a kid with EBV Mono who wanted to play in a football game, and you were asked what you should do. The answer said don't let him play because of a possible splenic rupture, and that confused me a bit. EBV is not a reportable disease, and if you're worried about a rupture of the spleen, you could apply the same principle to many many viral, protozoan, bacterial, etc. diseases that could potentiall cause danger, yet are not reportable diseases. So is there a clear cut answer as to why you should tell someone so that the kid can't play?
     

    cdql

    Full Member
    10+ Year Member
    7+ Year Member
    Mar 19, 2006
    958
    4
    39
    Boston
    1. Medical Student
      If you're referring to the UW question, I think they're talking about merely declaring a kid uneligible to play. It doesn't say you have to go into further detail about his disease with the coaching staff. It's also the "most appropriate answer" as we're supposed to care for our patients without regard to the wants of the fans/coaching staff/etc... etc...
       

      Taus

      .
      Staff member
      Administrator
      Volunteer Staff
      Verified Expert
      15+ Year Member
      Feb 1, 2005
      4,203
      958
      Philly
      1. Attending Physician
        I'm pretty sure it has nothing to do w/ the reportable nature of the disease here.....its just the EBV causing massive proliferation of B's (and T's->the atypical lymphos) in the spleen pre-dispose it to rupturing wayyyy more then your standard infection
         

        Southpaw

        Full Member
        Lifetime Donor
        15+ Year Member
        Aug 12, 2004
        2,429
        4,191
        1. Attending Physician
          It was confusing because another answer choice said that the patient ultimately makes the decision about his health care and the physician should not inform team administration. I thought this to be true. The correct answer words it as the physician should RESTRICT the player from playing. How exactly would he do that if we was not going to report the player? Had the correct answer said something to the effect of "strongly advising against playing" along with watching out for his best interests of health, I'd thought it to be more correct.

          I don't see the situation much different from spousal abuse. We don't report that, we simply support the patient, refer her to a shelter if wanted, and advise her to go to law enforcement. Yet we don't RESTRICT her from going back home to an abuser, which is the wording used in the correct answer by UW.

          I know it's very nit-picky, but I've heard these questions are very nit-picky on the real exam, so I think the wording is important.
           
          About the Ads

          justsomeguy

          New Member
          10+ Year Member
          Feb 3, 2007
          10
          0
            It was confusing because another answer choice said that the patient ultimately makes the decision about his health care and the physician should not inform team administration. I thought this to be true. The correct answer words it as the physician should RESTRICT the player from playing. How exactly would he do that if we was not going to report the player? Had the correct answer said something to the effect of "strongly advising against playing" along with watching out for his best interests of health, I'd thought it to be more correct.

            I don't see the situation much different from spousal abuse. We don't report that, we simply support the patient, refer her to a shelter if wanted, and advise her to go to law enforcement. Yet we don't RESTRICT her from going back home to an abuser, which is the wording used in the correct answer by UW.

            I know it's very nit-picky, but I've heard these questions are very nit-picky on the real exam, so I think the wording is important.

            I was confused, too, because I remember learning that people have the right to refuse life-saving treatment as long as they are competent and they understand what will happen by refusing treatment. At first I thought that this was the same principle being described here: that as long as the player was competent and understood the risks, the doctor could not do much to restrict the player from playing (other than strongly advising against).

            But, I think I have an interpretation of this question, but I am not sure that it's correct. From the way the explanation was written, I think that the answer to this question applies to the very specific situation of a doctor in charge of taking care of athletes (sports doc). It's like getting a physical before playing and if the physical turns up something bad (e.g. heart condition), you don't get to play until it is taken care of. The sports doc's number one job is to ensure the safety of the players. If the player were to go on the field and die from a ruptured spleen, the doctor would have failed his duty as the team's physician. Besides, back in my high school sports days, I remember the coach would always ask the trainer if injured so-and-so was fit to play, and if the trainer said "no", then that player didn't play.

            I could be dead wrong in this thinking, though, so any other input would be greatly appreciated.
             

            ginger60

            Full Member
            10+ Year Member
            Jan 14, 2007
            165
            0
            1. Resident [Any Field]
              I'm assuming this question is referring to a high school kid in a school sports program, in which case the kid is most likely not legally competent (as he is a minor) and thus can't really refuse treatment on his own. I think the previous poster is right about thinking of this as a sports doc kind of thing, or a pcp clearing the kid for a sports physical. In that case the doc has a duty to restrict the kid from playing because of a potentially life-threatening complication, which presumably is accomplished by declaring him ineligible to play contact sports. In reality I don't know how far you can take this--whether you just give the kid/parents a note and expect him to show it to his coach, but in theory the kid should be restricted from playing.
               
              This thread is more than 14 years old.

              Your message may be considered spam for the following reasons:

              1. Your new thread title is very short, and likely is unhelpful.
              2. Your reply is very short and likely does not add anything to the thread.
              3. Your reply is very long and likely does not add anything to the thread.
              4. It is very likely that it does not need any further discussion and thus bumping it serves no purpose.
              5. Your message is mostly quotes or spoilers.
              6. Your reply has occurred very quickly after a previous reply and likely does not add anything to the thread.
              7. This thread is locked.

              Similar threads