Ethics Flashcards
Procedure for ECT for involuntary patient
At least two authorised MOs (one of them must be a psychiatrist) should agree
Then (best approach) is to apply to Mental Health Review Tribunal for permission to perform ECT.
ECT without consent is wrong
ECT consented from higher authority or spouse is incorrect.
Infected with chlamydia and refuses to tell partner
Still has to report to department of health within 5 days of diagnosis as it is a notifiable disease
Reassure patient that name code will be used
Friend claims patient is Jehovah’s Witness, but no documentation. Requires emergency surgery and blood transfusion. Cannot contact family.
Transfuse as patient in critical condition requiring life-saving treatment.
Friend is not an appropriate surrogate.
Family members are, but uncontactable in this case.
Driving restriction post acute MI
2 weeks for private vehicles
4 weeks for commercial vehicles
For children who need urgent transfusion but parents wouldn’t allow due to religion, what to do?
Transfuse!
Only for adults do you respect their beliefs.
Describe
- Transgender
- Cross dresser
- Bigender individual
- Transvestites
- Transsexual
- Transgender: umbrella term for those who cross culturally defined gender categories
- Cross dresser: only wears clothes of the other gender, does not completely identify as the other gender
- Bigender individual: identify as both genders
- Transvestites: dress as another gender, have not considered surgery
- Transsexual: wish to change their sex, have considered/undertaken surgery
Unemancipated (< 18 years old) child.
Parents divorced on joint custody.
Each parent are able to consent, but consent from one parents is all that is necessary with treating the minor.
If both refuse, but life-saving treatment is required, physician needs to seek court approval before administering necessary but nonurgent treatment.
Physicians should also provide care in urgent situations without waiting for parental consent.
Circumstances in which minors can provide their own consent
Huntington Disease
Genetic Testing guideline
Eligibility:
Must be at least 18 years old and should have a family member with Huntington Disease
Autosomal dominant
50% chance of inheriting
Physician-assisted suicide
Legal or Illegal in Australia?
Illegal.
If patient has terminal illness, refer to palliative care for comfort measures.
Unwanted sexual intercourse on a 16-year-old living independently and supports herself financially
Management
Refer to sexual assault counsellor (not CPC)
- as she is independent, emancipated (free from parents)
Do forensic examination
Emergency contraception
Prophylaxis for STI
- follow up at 2, 6, 12 weeks following STI checks
If she is harmed/abused AND child’s parents have not protected/unlikely to protect the child from harm, then only inform CPC. But this person considered having capacity to make decisions.
How old are Australians considered independent individuals?
16 years old
17 years old in SA and ….?
South Australia
How old onwards is a child allowed to consent to their own medical treatment?
16 years old in South Australia, as long as
- they understand the nature, consequences and risks of the treatment
- opinion is corroborated in writing by at least one other medical practitioner who has personally examined the child before the treatment was commenced.
[Common Law determined to be “Gillick’s Compresent” or a “mature minor”: 18 years old - the age they become an adult]
Drugs that prevents narcolepsy
modafinil (Modavigil or Provigil)
[think of “vigilance”]
How long is a referral valid for?
A referral is valid for 12 months (one year) from the date of the first specialist visit, not on the date the referral was written.
Other rules:
- Referrals from a specialist are valid for only three months (after the first visit by the practice the patient has been referred to)
- A referral for admitted patients is valid for three months, or the duration of admission, whichever is longer
