Ethics Flashcards
Next of kin is identified for a woman who is estranged from her family, and found at home unresponsive with needles, and is a drug addict. When they get her to hospital she dies. They find her next of kin (her brother)
a. If police declare it a possible murder then you can ask the coroner
b. You can refer to coroner for autopsy if the police rule it as a suspicious death provided you get consent from the next of kin first
c. Perform a post-mortem at the hospital after seeking permission from her brother
d. Refer to coroner (for advice) as cause of death is unknown
e. Need brother’s consent to refer to coroner as cause of death is unknown
d. Refer to coroner (for advice) as cause of death is unknown
Random doctor following a needle stick injury, from a parent who has come back from the Philippines. Random doctor doesn’t want to take PEP unless risk is real. Asks patient (who has capacity) if they can consent to the blood test – patient refuses. The doctor then asks CT1 college if they can ask the lab to do a test on one of the patient’s old blood samples. What does the CT1 say?
a. The answer is if they decline to consent and have capacity then you cannot do the test
b. To not do the test would violate the doctor’s human’s rights under article 3 or 5 of the Human Rights acts of 1998
c. To not do the test would violate the patient’s human’s rights under the Human’s right’s act of 1998
d. If the hospital refuses to test the blood despite the person’s protests, then they are violating the doctor’s human rights.
e. They can proceed and test an old sample of blood as it is in the best interests of the doctor.
a. The answer is if they decline to consent and have capacity then you cannot do the test
Random doctor following a needle stick injury, from a patient who has come back from the Philippines. Random doctor doesn’t want to take PPE unless risk is real. Asks patient if they can consent to the blood test – patient too ill to consent/unconscious. The doctor then asks CT1 college if they can ask the lab to do a test on one of the patient’s old blood samples. What does the CT1 say?
a. You can’t do it
b. To not do the test would violate the doctor’s human’s rights under article 3 or 5 under the Human Rights acts of 1998
c. If the hospital refuses to test the blood despite the person’s protests, then they are violating the doctor’s human rights.
d. Wait until the patient is conscious to take consent.
e. The classic, ‘it’s okay if you can get a next of kin to consent on their behalf’
a. You can’t do it
A man presents with history of heart disease, left ventricular hypertrophy, has a facial basal cell carcinoma and type 2 diabetes. Investigations from one year ago showed critical aortic stenosis, with poor ejection fraction. Current echo shows critical aortic stenosis. They suddenly die. List the order for the coroners / How should you fill out the MCCD (Medical Certificate of Causes of Death)?
a. 1a = Acute left ventricular heart failure, 1b = Type 2 Diabetes
b. 1a = Aortic Stenosis, 1b = Type 2 Diabetes
c. 1a = Aortic Stenosis, 1b = Basal Cell Carcinoma
d. 1a = Aortic Stenosis, 1b = Basal Cell Carcinoma, Type 2 Diabetes
e. 1a = Aortic Stenosis, 2 = Type 2 diabetes
e. 1a = Aortic Stenosis, 2 = Type 2 diabetes
PMHx dies suddenly playing football. HOCM is determined to be cause of death at coroner’s postmortem. Pathologists wants to retain the heart for teaching purposes. The mother agrees but the 26 y/o brother is completely opposed. What is the legal position on organ retention in this situation?
a. After coroner’s post-mortem, organ tissue retention is required as evidence for cause of death
b. Organ or tissue retention can lawfully proceed with mother’s consent
c. Organ or tissue retention can’t lawfully proceed with family disagreement
d. Organ of tissue retention after coroner’s autopsy doesn’t require consent
e. Organ or tissue retention for the purpose of medical education does not require the family’s consent
b. Organ or tissue retention can lawfully proceed with mother’s consent
31 y/o man found unconscious in a flat surrounded by empty whiskey bottles and recreational drugs. Suffers cardiac arrest shortly after arriving in A&E and dies. Cause of death recorded as “being a fucking legend”. Brother arrives at hospital later and says his brother had alcohol-related seizures but hadn’t seen his doctor in years. What should be done regarding a post-mortem?
a. If the police suspect the death is criminal, it should be referred to the coroner for autopsy
b. This case should be referred to the coroner for autopsy
c. The cause of death is likely to be drug and alcohol related so autopsy isn’t needed
d. Cause of death is uncertain so post-mortem is preferable
e. Cause of death is uncertain so post-mortem is preferable but brother’s consent is needed
b. This case should be referred to the coroner for autopsy
A 24 y/o single man with cystic fibrosis and severe learning disability (mental age 4) is admitted to hospital with pneumonia and later dies. His mother died 10 years ago and he has since been cared for by his step-father, who has requested a post-mortem. However, the sister is deeply opposed to a post-mortem. The coroner says they do not need to perform a coroner’s autopsy. What should be done?
a. A post-mortem can’t be done without the coroner’s request
b. Provided one family member consents, the post-mortem can be done in this situation
c. Provided the stepfather was next of kin, the post-mortem can be performed
d. The post-mortem cannot be done if sister refuses
e. If the family disagrees, it must be referred to the Court of Protection
d. The post-mortem cannot be done if sister refuses
56 y/o man is admitted with reduced consciousness, fever, and seizures. MRI shows hydrocephalus and lesions suspicious for neurocysticercosis – a parasitic disease contracted by eating pork. The man dies a few days later. The patient’s wife says she and her husband were orthodox Jews and does not want this case discussed with the coroner, as she is anxious they will request a post-mortem confirming neurocysticercosis. What should be done?
a. Explain to the wife that the right to confidentiality does not extend till after death
b. Disclosing information to the coroner would breach the wife’s article 8 right to a private life under the Human Rights Act 1998
c. The wife has an absolute right to confidentiality so her request must be respected
d. There is a legal duty to disclose relevant information to the coroner regardless of consent
e. Non-disclosure to the coroner is legitimate if made on religious grounds
d. There is a legal duty to disclose relevant information to the coroner regardless of consent
63 y/o man is admitted with decompensated liver failure and hepatic encephalopathy, and is GCS 7. He is found to have previously undisclosed Hepatitis C infection. His wife asks for information about her husband’s health. He is acutely confused but the consultant thinks he will be lucid in a few days’ time. What should be done?
a. Disclosure should wait until the man has regained capacity to consent to disclosure
b. Disclosure should wait till the mode of transmission of Hepatitis C has been confirmed
c. Failure to disclose her husband’s Hepatitis C infection at the earliest reasonable opportunity breaches the wife’s right to life under article 2 of the Huma Rights Act 1998
d. This man lacks capacity, so the wife should be told of the Hepatitis C infection as she is next of kin
e. The wife may have contracted Hepatitis C from her husband and so should be told of the diagnosis
a. Disclosure should wait until the man has regained capacity to consent to disclosure
A homeless man dies (signs of trauma), you cannot contact his brother, what do you do about the autopsy?
This death must be referred to the coroner for autopsy as it is suspicious, so you don’t need consent from the brother
HIV positive girl dies of cerebral toxoplasmosis, before she dies she says she doesn’t want to disclose her HIV status. What do you write on the death certificate?
You must disclose it if it contributed to the death
Woman (45y) with learning difficulties and cerebral palsy, she gets influenza, then strep pneumonia, then dies of cardiorespiratory arrest. Death certificate.
1a Streptococcal pneumonia
1b Influenza
2 Cerebral palsy
Man dies, daughter consents to autopsy, step mum (his wife) does not want autopsy – what to do?
No autopsy, step-mum outranks daughter (order is:
- spouse/ partner,
- child/ parent,
- brother/ sister,
- grandparent or grandchild, etc. – see section 27 (4) of Human Tissue Act)
Guy with brain mets from lung cancer, has a PE, dies of cardiorespiratory arrest. Fill out death certificate
1a: Pulmonary embolism
1b: Cerebral metastases
1c: Lung cancer
(Assuming the PE was due to increased coagulability due to cancer)
What to put on death certificate for a well-controlled HIV patient who had a PE after a long haul flight and died from cardiac arrest soon after admission to hospital.
a. 1a: PE
b. 1a: PE, 1b: HIV
c. 1a: cardiac arrest, 1b: HIV
a. 1a: PE
