Ethics

Question 1

True or false: Adults of sound mind are allowed to refuse life-saving treatments.

Answer 1

True. You should not force blood products, antibiotics, or any other tx on a pt who does not want them.

Question 2

What should you do if a child has a life-threatening condition and the parents refuse a simple, curative tx (e.g. antibiotics for meningitis)?

Answer 2

First try to persuade the parents to change their minds; if this fails, attempt to get a court order to give the tx. Do not tx until you have talked to the courts if you can at all avoid it. Even with Jehovah’s witnesses who do not want their children to receive blood transfusions, you should seek the court’s assistance in getting the transfusion if it is the only tx option available.

Question 3

True or false: People with terminal illnesses can choose to die.

Answer 3

True. This is the rationale behind hospice care. Let competent people die if they want to do so. Do not commit active euthanasia, but respect a pt’s wishes for passive euthanasia.

Question 4

What is the difference between active and passive euthanasia?

Answer 4

Active euthanasia is the intentional hastening of death, whereas passive euthanasia is withholding txs and “letting nature take its course.”

Question 5

With whom can you discuss your patient’s condition?

Answer 5

Only with people who need to know because they are directly involved in the pt’s care and with people authorized by the pt (e.g. authorized family members). Do not tell a medical colleague who is uninvolved with the pt’s care how that pt is doing, even if the colleague is a friend of yours or the pt.

Question 6

In what situations are you allowed to breath pt confidentiality?

Answer 6

• Pt asks you to do so
• Child abuse is suspected
• Courts mandate you to do so
• You must fulfill the duty to warn or protect (e.g. if pt says he is going to kill someone or himself)
• Pt has a reportable dx
• Pt is a danger to others (e.g. pt is blind or has seizures, let the proper authorities know so they can revoke pt’s license to drive; if the pt is an airplane pilot and is a paranoid, hallucinating schizophrenic, then authorities need to know)