18. Ethics/legal/professional

Question 1

What do you do if a pregnant woman wants a vaginal delivery when the baby is in distress and needs a c-section?

Answer 1

Respect the patient’s decision and proceed with vaginal delivery - a pregnant woman who has capacity has the right to refuse treatment, even if it places her unborn child at risk

Question 2

If a patient refuses potentially life-saving tx, what should the physician do?

Answer 2

Fully discuss WHY the patient is making the decision before honoring it

Question 3

What are the rules regarding accepting gifts?

Answer 3

Only nonmonetary gifts that are of minimal value and that directly benefit the patient, such as unbiased educational material or drug samples should be considered

Question 4

What is one of the largest contributors to medical errors and adverse patient outcomes? Solution?

Answer 4

Communication failures between docs during patient handoffs

Solution: implement signout checklist

Question 5

If a parent refuses to consent to treatment of their child for a non-emergency, but fatal medical condition, what should the physician do?

Answer 5

Seek a court order mandating treatment

Question 6

If a patient has boundary issues (arriving at unscheduled times/closing time, freq return visits for nonspecific complaints, insisting on seeing the same Dr each visit, and complaints that necessitate examination of private areas) how should you manage the patient?

Answer 6

Maintain a therapeutic distance - only see if they have a scheduled appointment and with presence of another staff member

Question 7

Physicians should be suspicious for what in kids with sudden behavioral problems, stressful family environments, or parents with active drug/ETOH abuse?

Answer 7

Physical or sexual abuse

Note: if confirmed, the physician is mandated to report it

Question 8

If parents are themselves minors, can they give consent for medical tx of their child? What do you do if they refuse a potentially life-saving procedure or tx?

Answer 8

Yes

If there are challenges in getting consent, do not delay the procedure - informed consent is not required.

Question 9

When caring for an unemancipated minor, what do you do if you have informed consent from one parent but not from the other?

Answer 9

It is sufficient to proceed with one parent’s consent.