2. Ethics and professionalism

Question 1

Patient in 30’s with learning difficulty, has a slowly leaking abdominal aneurysm and needs vascular surgery or else will die. Surgeons have offered to do it but 50% success rate. Mother of patient demanding they have the operation. Discuss the ethics within this:

Answer 1

• does patient have capacity (Retain info, Act on, Communicate, Understand, Make reasoned decision)
• can the patient consent
• if the patient cannot consent then does the parent have power of attourney and is this for welfare/finances/both
• although power of attourney in place doctors still need to propose appropriate management plan and it is a medical decision at the end of the day, just should take into account the wishes of the POA
• think about quality of life, what the person can do now, what they will be able to do after the operation
• beneficence (act in best interests of the patient both medically and non-medically)
• non maleficience (literally do no harm medically)

Question 1

80yr male has haemorrhagic stroke. Daughter has read about thrombolysis and asks you to do this as she is power of attourney.
Discuss the ethics within this:

Answer 1

u

Question 2

What are the components of the mental health act?

Answer 2

d

Question 3

Paediatric non-accidental injury scenario (DFTB module)

Answer 3

d

Question 4

Child wanting contraception and parent in the room…

Answer 4

If you are <16 and have RACUM then you are deemed Gillick competent and can consent to treatment without parents having to know or parents having to agree

Fraser guidelines apply specifically to contraception prescribing