42. Medical Ethics

Question 1

You are starting your OB/GYN rotation. Your preceptor is a 75 year old man that should probably retire. When observing a vaginal delivery he performs an episiotomy. When you ask him why he does the procedure he states, “well, I don’t know, it is just the way I have been doing it since I started.” You feel that the patient was not in need of the episiotomy and has complications later on due to the procedure. When reflecting on the ethics of the situation –which criteria would you use to determine the strength of evidence in favor of or against the procedure?

A. Currency
B. Relevance
C. Accuracy
D. Authority 
E. Purpose

SZ

Answer 1

Ans A Currency

The physician is using an ‘old technique’ and new research highlights possible complications due to episiotomies. He is not current on his techniques and therefore the patient is suffering.

Question 2

Which of the following are the 3 criteria that define capacity?

A. Ability to understand, make a decision, sign an advanced directive
B. Ability to understand, make a decision, and communicate the decision
C. Ability to express after death wishes, understand current health status, ask questions
D. Ability to have brain function, respiratory and cardiac function
E. Ability to be mentally aware, oriented x3

SZ

Answer 2

Ans B

Capacity is the ability to understand, ability to make a decision, and the ability to communicate that decision.

Question 3

An ob/gyn physician has a pregnant patient that is at 32 weeks gestation. A last minute opening at a medical conference a few states away makes the physician REALLY want to go. The conference is discussing some cutting edge research on improving the survivability of premature newborns, and attending the conference could help the physician save more lives. Would attending the conference violate the tenant of a field of ethics since her patient is so near due in her pregnancy, and if so, which field would be violated? (MG)

A. This is NOT a breach of ethics
B. Yes- Bioethics
C. Yes- Medical ethics
D. Yes- Clinical ethics

Answer 3

C. Yes- Medical ethics

This is a breach of duty to the patient, as the pregnant patient and the ob/gyn have an existing treatment relationship

Question 4

Match the correct definition to the 3 fields of ethics we have discussed. (MG)

Bioethics
Medical Ethics
Clinical Ethics

A. The duty of physicians to patients and society
B. Start and end of life care, specifically in resolving dilemmas about these things
C. Ethics for medicine and all health careers, living things, and life sciences

Answer 4

Bioethics: C
Medical Ethics: A
Clinical Ethics: B

Side note: bioethics includes medical and clinical ethics (it is a broader term and also a field of study)