Ethics questions...

[student456]

1- Woman refuses treatment for her unborn child.

--I think we can't do anything as she's the one carrying the fetus. We can start treatment once she has delivered the baby, am I right? For the USMLE, is there anything else we need to tell her or we need to do?
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Found these questions online for practicing more questions, but there are no answers:

1.A young man is brought to the ER after a MVA. It was a head on collision between a small car and his truck. The old lady driving the car died on the spot. This young man has a few bruises on his chest and abdomen. He is otherwise stable and seems to have no serious injuries. In the mean time police arrives and ask you to with draw some blood for the blood alcohol levels. What you will do?

A. Ignore the police
B. Order the nurse to withdraw blood and label it and send it to the laboratory
C. Make a telephone call to the laboratory staff and request them as if they could
do the blood alcohol from the same amount of blood sent for other investigations.
D. Tell the police that you need to take consent from the patient


2.Now you have ordered the laboratory for the blood alcohol level. What will you
tell the police?

A. Ignore the police
B. Tell the police that this is confidential information and you cannot hand it over
to them.
C. Just write your orders on the paper and leave rest to the Hospital staff nurse
to deal with the police
D. As soon as you receive the results of the investigations, hand them over to
the police
E. Tell the police that they have to bring the subpoena
F. Tell the police that they have to bring the court order

3. A 45 years old man comes to you with a H/O dysuria. You suspect him for Gonococcal urethritis. He requests you to code his specimen without his name as his wife works in that laboratory and reads all the reports. What you will do?

A. Send a coded sample to the lab.
B. Convince him to disclose this to his wife.
C. Send the specimen to another lab.
D. Tell the patient that you cannot send the coded sample.


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My answers-----Am I right? Please, explain.


1- D
2- F
3- C

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When a teenager wants an abortion, after informing the parents do we also need consent from the parents?

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[tasar1898]

I am only 100% sure about the last question with the abortion because I read it on Uworld ... It is still debated in the US , a few states require only notification , but the majority need parental consent if the teenager is not emancipated , so you usually ''encourage discussion'' ....In any case , the parents are always being made aware .

In the mother q , I think it's her body = her choice (e.g. if a choice should be made between survival of mother and fetus/child , then the doctor has no place deciding and there is nothing he can/should do , the mother/family decides)

I hope someone can enlighten us on the rest...

 

[pulmoblast]

1.A woman can refuse treatment for her unborn child
2. You order blood alcohol levels if clinically indicated, such as, AMS or risk of withdrawl etc. The police has to get a judicial order to get a copy of those results. In my ER, if a blood alcohol level is needed solely for legal purposes, they need informed consent. The blood alcohol test is done by special phlebotomist and done in a different accredited lab for medicolegal purposes. Defense lawyers can throw the result out of the window otherwise for many reasons (such as the needle was contaminated by alcohol wipe used to swab the skin) however funnily the blood alcohol level that we order for a medical indication can still be valid in court even if it is done by regular staff in our lab. Short answer D
3. F
4. Send the specimen to another lab

 

[student456]

Thanks for responding... I'll stick to what you guys are saying.

Some more questions for discussions to be clear.
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Q1 -- A teenager who lives with parents wants bilateral vasectomy? What should be done?
Q2- Can we treat our own family members or relatives?
Q3- Is donating organ for money allowed?
Q4- Is sex selection allowed?
Q5-Can docs refuse to treat TB or HIV pts and refer them to other do who are willing to treat them?
Q6- To confirm pt brain dead, we need 2 doctors for diagnosis?
Q7- Brain dead pt with a card of organ donation, but family refuses? Should you remove organs?
Q8- If doctors are given gifts when they are off duty from companies or patients, can they accept any gifts?
Q9- If a male doc is examining an adolescent or adult female pt, do they always need a chaperon? And same for female docs who examine young male pts? Are their parents ok for chaperon? or nurse?

Q10- If patient is not happy with us, aren't we supposed to figure out why and then make improvements instead of referring them to other doctors? Question below says otherwise.

Q--An internist has been managing a diabetic patient for the last 10 years. The patients
condition is progressively getting worse. The patient is also not happy with the physicians
management. What should a physician do in this situation?

Answer------- physician should find another physician (e.g., endocrinologist) who might be more successful with the patient in this particular circumstance.





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[FA2014]

Thanks for responding... I'll stick to what you guys are saying.

Some more questions for discussions to be clear.
--------------------------------------------------------------------------------------------

Q1 -- A teenager who lives with parents wants bilateral vasectomy? What should be done?
Q2- Can we treat our own family members or relatives?
Q3- Is donating organ for money allowed?
Q4- Is sex selection allowed?
Q5-Can docs refuse to treat TB or HIV pts and refer them to other do who are willing to treat them?
Q6- To confirm pt brain dead, we need 2 doctors for diagnosis?
Q7- Brain dead pt with a card of organ donation, but family refuses? Should you remove organs?
Q8- If doctors are given gifts when they are off duty from companies or patients, can they accept any gifts?
Q9- If a male doc is examining an adolescent or adult female pt, do they always need a chaperon? And same for female docs who examine young male pts? Are their parents ok for chaperon? or nurse?

Q10- If patient is not happy with us, aren't we supposed to figure out why and then make improvements instead of referring them to other doctors? Question below says otherwise.

Q--An internist has been managing a diabetic patient for the last 10 years. The patients
condition is progressively getting worse. The patient is also not happy with the physicians
management. What should a physician do in this situation?

Answer------- physician should find another physician (e.g., endocrinologist) who might be more successful with the patient in this particular circumstance.
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I'm with you guys. I also need help with ethics and the more practice we get the better.


Q1 -- A teenager who lives with parents wants bilateral vasectomy? What should be done?

My ans ---We need need to offer other options.

Q2- Can we treat our own family members or relatives?

-No, they need their own doctors

Q3- Is donating organ for money allowed?

I'm not sure.... Can anyone help with this one?

Q4- Is sex selection allowed?

I'm not sure.

Q5-Can docs refuse to treat TB or HIV pts and refer them to other do who are willing to treat them?

Yes, we can refer the pt to other doctor.

Q6- To confirm pt brain dead, we need 2 doctors for diagnosis?

I think we do to be sure that pt is really dead, but not sure.

Q7- Brain dead pt with a card of organ donation, but family refuses? Should you remove organs?

I say yes, not sure.

Q8- If doctors are given gifts when they are off duty from companies or patients, can they accept any gifts?

I think the rules that apply during work also applies off duty, but is it really like that in reality?

Q9- If a male doc is examining an adolescent or adult female pt, do they always need a chaperon? And same for female docs who examine young male pts? Are their parents ok for chaperon? or nurse?

Yes, when examine younger patients we need chaperons, but who can be it, I'm not sure.

Q10- If patient is not happy with us, aren't we supposed to figure out why and then make improvements instead of referring them to other doctors? Question below says otherwise.

I thought we can never refer patients so not sure.

Q--An internist has been managing a diabetic patient for the last 10 years. The patients
condition is progressively getting worse. The patient is also not happy with the physicians
management. What should a physician do in this situation?

Answer------- physician should find another physician (e.g., endocrinologist) who might be more successful with the patient in this particular circumstance.