UW ethics

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Reperfused

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Some of the UW ethics questions are really making me doubt the ethics knowledge I've gained so far from other resources (e.g. Kaplan, RX, FA etc)

Like there's this question about incapacitated patient and the need of intubation. Patient is unmarried and lives alone. He has a sister who lives in the area but qs doesn't tell us when did he last spoke to her.
Now this patient was accompanied by his friend who says they're good buddies and they've discussed this topic of death before and the patient never wanted to go for intubation/ventilator.

This sounds like "substituted judgment". So I thought we should go with what the friend says. Because friend is conveying the real wishes of the patient.

Still, the answer was to attempt to contact the sister. Huh?

According to my knowledge, you always listen to the person who's closest to the patient in recent times.
For example, for an elderly patient, you would rather listen to what the nurse says who was the caregiver for the patient during the last 5 years and patient spent most of her time with. Because she would know patient's wishes the best. Instead of a son whom the patient haven't met in ages!

Someone please clarify this concept to me. Thanks

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The way I see it is if a one is going to file a lawsuit it's going to be his sister and she has to be part of the decision making process even if the patient wishes is what determines what will be done to him after all.
 
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Some of the UW ethics questions are really making me doubt the ethics knowledge I've gained so far from other resources (e.g. Kaplan, RX, FA etc)

Like there's this question about incapacitated patient and the need of intubation. Patient is unmarried and lives alone. He has a sister who lives in the area but qs doesn't tell us when did he last spoke to her.
Now this patient was accompanied by his friend who says they're good buddies and they've discussed this topic of death before and the patient never wanted to go for intubation/ventilator.

This sounds like "substituted judgment". So I thought we should go with what the friend says. Because friend is conveying the real wishes of the patient.

Still, the answer was to attempt to contact the sister. Huh?

According to my knowledge, you always listen to the person who's closest to the patient in recent times.
For example, for an elderly patient, you would rather listen to what the nurse says who was the caregiver for the patient during the last 5 years and patient spent most of her time with. Because she would know patient's wishes the best. Instead of a son whom the patient haven't met in ages!

Someone please clarify this concept to me. Thanks
In this scenario "attempt to contact the sister" is almost analogous to choosing "perform a H&P on the patient". You're operating on incomplete information-- you need to obtain more information before making a decision.
 
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It totally makes sense the way you two have explained.

So I'm concluding that my concept was correct but application was wrong. Any idea on how to improve on this? Just by continuing to do more questions?

I've already finished RX(did it pretty thoroughly), UW is my second qbank. I was hoping to perform better on it. But unfortunately I'm not :(
 
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