2. Scenarios Flashcards
A patient has a BMI of 45, and is therefore morbidly obese. Should you offer bariatric (weight loss) surgery?
(1) Autonomy
(2) Beneficence
(3) Non-maleficence
(4) Justice
Patient wishes to end their life. What do you do?
(1) Autonomy
(2) Beneficence
(3) Palliative care
A Jehovah’s witness arrives in A&E unconscious, bleeding and in need of an urgent blood transfusion. What do you do?
(1) Stop the bleeding
(2) Autonomy
A mother comes into A&E with a child who is bleeding and refuses to allow you to administer a blood transfusion to the child. Why, and what do you do?
(1) Stop the bleeding
(2) Gillick competent?
(3) Not Gillick competent
(4) Mother worried about the procedure
(5) If mother still refuses
A 14 year old girl presents to you asking for termination of pregnancy. What are the issues?
(1) Confirm pregnancy & age
(2) Fraser competent?
(3) Not Fraser competent
A patient requests a HIV test. What do you think about?
x
HIV patient of a few months is reluctant to disclose status to his wife.
(1) Discuss why the patient may be worried about disclosing his status
(2) Given that his wife has not been informed, I’d have to consider whether the wife is at risk
(3) In what circumstances would you breach confidentiality?
Elderly lady refuses to take medication for her heart attack, which exposes her to serious risks including death. She brings her husband to a consultation who asks you talk sense into her.
(1) Confidentiality
(2) Autonomy vs beneficence
(3) Patient has a specific reason not to take medication?
Patient asks for advice about a non-conventional treatment they have found on the internet.
(1) Benevolence and non-maleficence
(2) Patient’s motivation
(3) Patient safety
A young woman presents with rheumatoid arthritis. She has tried all conventional treatments but is still having problems. Unless her symptoms improve, she will have to give up work in the near future. There is new but expensive treatment available. Treatment for a single patient costs as much as conventional treatment for 10 patients. The drug is not effective in all patients and in some cases gives rise to a worsening of the symptoms. What do you do?
(1) Autonomy
(2) Beneficence and non-maleficence
(3) Justice
What would you do if an obese patient demanded an immediate total hip replacement, which will fail in 6 months?
(1) Autonomy
- Nature of problem
- Enlist help
- Ensure pain relief
- NHS resources being optimised
(2) Justice
You have one liver available for transplant and must choose one of two possible patients on the transplant list, an ex-alcoholic mother with 2 young children or a 13-year-old child with a congenital liver defect.
(1) Autonomy
(2) Beneficence and non-maleficence
- Biological factors
- Psychological factors
(3) Justice
As Health Secretary, you have been given the choice between two options: a treatment that will relieve the pain of arthritis sufferers and a surgical procedure designed to repair a hole in the heart of neonates. Both treatments have the same overall annual cost.
(1) Numbers
(2) Expenses
(3) Likely benefit to the individual
A long distance lorry driver has been diagnosed with diabetes, which he needs to control with daily injections of insulin (at least two) and a low sugar diet. His wife is not working, and they have 3 children under 18 who attend an expensive private school, and a large mortgage. Driving regulations are such that professional drivers who have insulin-controlled diabetes must demonstrate that their condition is under control, otherwise they lose their licence. What are the issues you, as a doctor, wish to address with the patient?
- Holistic medical advice
- Beneficence and non-maleficence
(1) Physical
(2) Psychological
(3) Social
(4) Financial
