Ethics AMC Flashcards
- A 25-year old mother refused immunization for her 2-month old son.
Immunization should be given for the benefit of the child.
- immunisation is not by force
- A 30-year old mother refused surgery for suspected appendicitis for her 6-year old daughter.
Surgical removal of the appendix should be performed for the benefit of the child.
- A 16-year old boy diagnosed with osteosarcoma refuses amputation despite it being life-saving.
Amputation should NOT be performed.
- A 17-year old Jehovah’s Witness girl refuses a lifesaving blood transfusion.
Blood transfusion should NOT be given because she is competent to make the decision.
- A 5-year old Jehovah’s Witness girl needs emergency blood transfusion, mother refuses.
Blood transfusion should be given because the patient is not competent; mother cannot refuse treatment.
- A 2-year old boy is diagnosed with child abuse, parents request confidentiality.
The case should be reported to Child Welfare Agency (CWA); children should be removed from parents.
- A 15-year old boy with STD asks physician not to tell parents.
Physician should treat patient, notify appropriate health authority, but not tell parents.
- A 16-year old boy requests condoms without informing parents.
Condoms should be given; physician should not inform parents.
- A 30-year old man with HIV requests physician not to tell his wife.
Physician should notify appropriate authority for safety, urge patient to disclose to wife.
- A newborn is not resuscitated per mother’s decision; she understands implications.
Physician is not liable for newborn’s death; no liability for withholding life-sustaining treatment.
- Physician picks up car accident victim, resulting in quadriplegia.
Physician is liable for consequences due to inadequate neck protection.
- Policeman asks physician to insert nasogastric tube against patient’s refusal.
Nasogastric tube should not be inserted; blood alcohol level should be tested.
- 60-year old man with myocardial infarction needs resuscitation by another department’s physician.
Physician must resuscitate patient; cannot refuse treatment based on department.
- 15-year old homosexual boy seeks help, asks physician not to tell parents.
Physician should help avoid homosexual activities; should not inform parents.
- 15-year old homosexual boy brought by parents who do not accept orientation.
Physician should inform parents of sexual orientation as an alternative lifestyle; should not force change.
- 16-year old girl becomes pregnant against mother’s wishes; wants to continue.
Physician should advise continuation of pregnancy; girl is competent to decide.
- 15-year old girl seeks abortion without parental notification.
Abortion should be done without notifying parents; strict requirements may deter seeking care.
- Physician provides sterile needles to intravenous drug abusers.
Yes, to reduce HIV or hepatitis risk; refer to appropriate health facilities.
- Pregnant woman refuses fetal blood transfusion for erythroblastosis fetalis.
Physician should seek court order for procedure benefitting fetus.
- 20-year old man threatens girlfriend; physician alerts university, no action taken.
Responsibility lies with the man for the killing; university also accountable for negligence.
- 20-year old pregnant woman refuses cesarean section for placenta previa.
Physician can seek court permission for cesarean section for fetal benefit.
- 30-year old pregnant woman abuses alcohol and drugs harmful to fetus.
Report to CWA if fetal urine toxicology positive; suggest separate custody if necessary.
- Physician wants to study 10-12 year olds; one child refuses participation.
Child can refuse participation in research study.
- 40-year old schizophrenic patient needs hernia repair; understands procedure.
Yes, patient can consent if understands procedure despite psychiatric condition.
- 65-year old schizophrenic patient needs coronary angiography; does not understand.
Relative can consent; obtain court order if no available relative.
- Postpartum woman consents to newborn’s cardiac surgery for congenital heart disease.
Yes, mother can consent if understands procedure.
- Parents request surgical repair for newborn with trisomy 18 or 13; non-viable condition.
Surgeon should refuse surgery; consider gastrostomy tube for nutrition if patient survives.
- Terminally ill patient requests medication to expedite death due to constant pain.
Physician cannot expedite death but can prescribe appropriate pain relief medication.
- Patient diagnosed with metastatic prostate cancer; physician must disclose diagnosis.
Yes, physician must disclose diagnosis to patient.
- Surgeon unsure of patient’s decision-making capacity for cholecystectomy.
Consult psychiatrist or neurologist; consider ethics committees or court involvement for complex cases.
- Comatose patient’s substitute decision-maker designated by written advance directive.
50-year old neighbor should make substitute decision based on advance directive.
- Patient’s right to refuse medical intervention, including life-sustaining treatment.
Patient can refuse treatment, not considered suicide; physician participation not assisted suicide.
- Medical student identifying as ‘doctor’ to patient.
No, patient can refuse procedures by medical student; procedures only with patient’s consent and appropriate supervision.
- Bus driver hides epilepsy from employer fearing job loss.
No, physician should encourage notifying employer; if not, notify appropriate authority for community safety.
- Patient requests physician not to tell wife about stomach cancer diagnosis.
Physician should encourage patient to disclose diagnosis to wife.
- Presymptomatic Huntington’s disease patient refuses to disclose diagnosis to wife.
Patient should seek genetic counseling and discuss with wife due to risk to future children.
- Meningitis patient refuses therapy and returns to college dormitory.
Physician should report to college authority; recommend isolation during illness.
- Nurse with hepatitis B antigen-positive does not disclose to hospital authority.
Physician should encourage nurse to disclose condition to hospital authority; if refusal, notify for patient safety.
- Patient needs neurosurgical intervention not accepted due to lack of medical insurance.
University hospital must accept patient regardless of insurance status.
- Patient needs second prosthetic valve; surgeon reluctant due to patient’s drug addiction.
Surgery should be performed if medically indicated, regardless of patient’s lifestyle.
- Anencephalic newborn’s kidney requested for transplant to sibling with renal failure.
Surgeon should perform kidney transplant if medically viable.
- Patient in persistent vegetative state; physician discontinues nutrition and hydration.
Yes, this is ethically acceptable in most states with appropriate evidence of patient’s wishes.
- Medical student requests pelvic examination on anaesthetized patient without consent.
No, procedure cannot be performed without patient’s consent.
- Unconscious patient brought to ER after wrist slashing; psychiatric and social evaluation needed.
Physician should provide care, evaluate psychiatric state with social worker involvement.
- Alzheimer’s patient with recurrent aspiration pneumonia; family decides against intervention.
Physician should respect family’s decision after discussion.
- Infant diagnosed with hypoplastic left heart syndrome; prostaglandin used to stabilize.
Parents can choose staged surgical repair, heart transplantation if available, or palliative care.
- Developmentally disabled woman with breast cancer; family declines intervention.
Discuss with hospital ethics committee; consensus often to refrain from intervention due to severe disability.
- Cervical cancer patient with history of noncompliance; surgeon wants to force chemotherapy.
No, patient must decide on treatment; physician can only educate and advise.
- Diabetic patient unhappy with management seeks another physician.
Physician should refer to another specialist who may better manage patient’s condition.
- Internist refuses to see patient due to rudeness; patient seeks records from new physician.
Internist should provide patient’s medical records to new physician upon request.
- An internist refused to see a complicated hypertensive patient who he has seen for the last 10 years…
yes. The legal charge of abandonment can arise when the physician without giving timely notice, ceases to provide care for a patient who is still in need of medical attention. Internist is not obligated to find him another physician. However, patient should have sufficient time to arrange for another physician.
- A physician went on vacation for 2 weeks. He did not find another physician to cover him…
yes. The physician has a legal obligation to arrange for coverage by another physician.
- An ophthalmologist performed a cataract surgery on a patient who went home after the operation…
yes. Ophthalmologist failed to judge the patient’s condition seriously enough to warrant attention.
