Ethical Situations and Appropriate Response Flashcards
What is the appropriate response:
Patient is not adherent.
Attempt to identify reason for nonadherence, determine willingness to change.
Do not coerce patient into adhering or refer him/her to another physician.
What is the appropriate response:
Patient desires an unnecessary procedure.
Attempt to understand why patient wants the procedure and address underlying concerns. Do not refuse to see patient or refer him/her to another physician.
Avoid performing unnecessary procedures.
What is the appropriate response:
Patient has difficulty taking medications
Provide written instructions; attempt to simplify treatment regimens.
Use teach-back method (ask patient to repeat medication regimen back to physician) to ensure patient comprehension
What is the appropriate response:
Family members ask for information about patient’s prognosis.
Avoid discussing issues with relatives without permission of the patient.
What is the appropriate response:
A patient’s family member asks you not to disclose results of a test if the prognosis is poor because the patient will be “unable to handle it”.
Attempt to identify why the family member believes such information would be detrimental to patient’s condition.
Explain that as long as patient has decision-making capacity and does not indicate otherwise, communication of information concerning his/her care will not be withheld.
What is the appropriate response:
A child wishes to know more about his/her illness.
Ask what the parents have told the child about his/her illness.
Parents of a child decide what information can be relayed about the illness.
What is the appropriate response:
A 17 year old patient is pregnant and requests an abortion.
Many states require parental notification or consent for minors for an abortion.
Unless she is at medical risk, do not advise a patient to have an abortion regardless of her age or the condition of the fetus.
What is the appropriate response:
A 15-year old girl is pregnant and wants to keep the child. Her parents want you to tell her to give the child up for adoption.
The patient retains the right to make decisions regarding her child, even if her parents disagree. Provide information to teen about practical issues of caring for a baby. Discuss the options, if requested. Encourage discussion between the teenanger and parents to reach the best decision.
What is the appropriate response:
A terminally ill patient requests physician assistance in ending own life.
In overwhelming majority of states, refuse involvement in any form of physician-assisted suicide. Physicians may, however, prescribe medically appropriate analgesics that coincidentally shorten the patient’s life.
What is the appropriate response:
Patient is suicidal
Assess seriousness of the threat; if it is serious, suggest that the patient remain in the hospital voluntarily; patient can be hospitalized involuntarilly if he/she refuses.
What is the appropriate response:
Patient states that he/she finds you attractive.
Ask direct, closed-ended questions and use a chaperone if necessary.
Romantic relationships with patients are never appropriate.
Never say, “There can be no relationship while you are a patient” because this implies that a relationship may be possible if the individual is no longer a patient.
What is the appropriate response:
A women who had a mastectomy says she now feels “ugly”.
Find out why the patient feels this way. Do not offer falsely reassuring statements (e.g., “You still look good.”)
What is the appropriate response:
Patient is angry about the amount of time he/she spent in the waiting room.
Acknowledge the patient’s anger, but do not take a patient’s anger personally. Apologize for any inconvenience. Stay away from efforts to explain the delay.
What is the appropriate response:
Patient is upset with the way he/she was treated by another doctor.
Suggest that the patient speak directly to that physician regarding his/her concerns. If the problem is with a member of the office staff, tell the patient you will speak to that person.
What is the appropriate response:
A drug company offers a “referral fee” for every patient a physician enrolls in a study.
Eligable patients who may benefit from the study may be enrolled, but it is never acceptable for a physician to receive compensation from a drug company. Patients must be told about the existence of a referral fee.
