pharmd2b2009

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Just wondering if i could get feedback from anyone who had situational dilemma questions during their interview.

i'm familiar with one of the questions:

would you sell birth control medication to an underage girl?

although i really don't know the best answer...my guess would be .Yes(however i would also notify the parents)....as there are more severe negative outcomes (early motherhood,etc)


ANY MORE EXAMPLES SIMILAR TO THESE?
 

OSURxgirl

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Does the girl have a prescription for the birth control?? And how young do you mean by "underage"? There's a big difference between 12 and 16 for example.
 

ultracet

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also you have to consider that you may not have the right to inform the parents...

i'm not really sure the scope of HIPAA on that one.. but i would say unless she wants her parents to know you couldn't tell...

i'm sure you didn't really want to debate your answer but... it looks like that's what you're getting right now! ;)

as far as other questions....
what would you do if you saw a friend cheating?
co worker stealing?
what if that person was your pastor's wife?
what if your friend's dad came in with a forged rx?
your uncle?

i can't think of anymore right off but we were discussing the other day in my human resources class that ethical questions are popular right now...
if you search around some have been posted previously
 

28657

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I'm pretty sure HIPPA only protects adults. So I think parents have access to any information about their children, thereby negating the legality issue.
But if it were me, I'd fill the script and I wouldn't call the parents. You'll most likely get an entire quarter of pharmacy ethics in pharmacy school. Let me tell you - it's loads of fun. :rolleyes:
 

chloejane

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I think 16 is the age at while someone can legally consent to a sexual relationship (although if the partner is much over 18, I believe there can be many legal ramifications then, ie. satuatory rape, ect.) So, if she was at least 16, I would not notify her parents and fill the rx- checking first of course if I'm right about the legal age. If I knew the age of the suspected boyfriend to be significantly older... I'm not sure... I would check my legal standing and verify my proof/facts before I made any action. Although I might not approve with this particular situation, I would prefer the girl be protected from pregnancy and I would mention to her that this is only a contraceptive but will not protect against any STDs (in that "I tell this to everyone" tone of voice, but please ask me questions when I enquire if you have any questions about your new script.) I admit though, I might be tempted to drop a subltle hint to the parents if I could in a way that didn't break patient confidentiality that might cause them to examine this situation more closely.
If she was under sixteen, one, I believe the MD may need parental notification at least to do the standard OB/GYN exam to even get BCs, so hopefully they would know, but if they didn't (or I didn't think so) I would check the legality of discussing this with them.

PS- I have no idea what the HIPPA stance is on any of this so if my answer totally violated that, sorry
 

dgroulx

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You can't assume that she is using the pills for birth control. She may have an irregular period or have really bad cramps. In any case, I would fill and not notify the parents. I believe someone's personal life should be kept private, regardless of their age.
 

Swenis

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dgroulx said:
You can't assume that she is using the pills for birth control. She may have an irregular period or have really bad cramps. In any case, I would fill and not notify the parents. I believe someone's personal life should be kept private, regardless of their age.
I concur. :thumbup:
 

ultracet

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chloejane said:
I think 16 is the age at while someone can legally consent to a sexual relationship

it varies state by state.....

most are 16 or older... but good ole' hawaii is 14 and in south carolina its 14 (only with parental consent)


now to address HIPAA:
The general principle used by HIPAA is a simple one: if a person has a right to make a health care decision, then he/she has the right to control information associated with that decision.

Parents generally have the right to make health care decisions for their children and so are by default considered the personal representatives for decisions about protected health information (PHI) access, use and disclosure for unemancipated minors. This would also be true in the case of a guardian or other individual acting in loco parentis. However, minors as they grow older have varying degrees of "emancipation" for health care decision-making, and so, with that, comes control over PHI associated with those decisions

Accordingly, the general rule of parental/personal representative control for minors' PHI is subject to three important general exceptions:

when state law does not require consent of a parent/personal representative before a minor can obtain a particular form of treatment (e.g., HIV testing, mental health services), the minor controls information associated with that treatment;
when a court determines or other law authorizes someone other than the parent to make treatment decisions for a minor, that other person or entity controls the information associated with the controlled treatment (it may in some cases be the minor him- or herself);
when a parent/personal representative agrees to a confidential relationship between a health care provider and a minor, the personal representative does not have access to information associated with that agreement (unless the minor permits it).
Even in these "exceptional" situations, however, state laws which specifically address disclosure of health information about a minor to a parent/personal representative preempt HIPAA, regardless of whether they prohibit, mandate or allow discretion about a disclosure. While HIPAA generally allows preemption by state privacy laws only where they are "stricter," this is an area of almost total deference.
That is what I found.

One of the posters was right about needing a pelving exam before most MDs will write for BC.

And then another was correct about the multiple uses for BC

i honestly know 12 year olds who have had a baby.... i would much rather dispense BC and prevent an unwanted preganancy (lets face it... she's going to have sex anyway if that's what it is for)
 

Caverject

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If a girl presented me with an RX for birth control, was under aged, the parents got their prescriptions at that store, and the paitent is hiding it from the parents, I would kindly tell the patient she is better off filling it elsewhere for her sake. And I would also recommend not going to walgreens or CVS or any chain that has interlinkage between stores.
 

bananaface

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AmandaRxs said:
I'm pretty sure HIPPA only protects adults. So I think parents have access to any information about their children, thereby negating the legality issue.
But if it were me, I'd fill the script and I wouldn't call the parents. You'll most likely get an entire quarter of pharmacy ethics in pharmacy school. Let me tell you - it's loads of fun. :rolleyes:
HIPPA does not specify age. It is up to the healthcare provider to decide if a parent is part of the healthcare relationship. Group Health treats all people 12 and older as adults. Other places do it at other ages. State laws of course trump HIPPA if more restrictive. Here in WA, if the parent is not a part of the healthcare process, we are free to presume that the child is competent to make their own decisions. I know of a case where emergency contraception was dispensed to a 12 year old. I would dispense regardless of age. People making adult decisions need adult resources. Frankly, if the law said I had to notify parents, I would be in favor of changing the law, as it would discourage patients from accessing medical resources. I don't feel that parental notification is conducive to an appropriate patient-provider relationship.