High Yield Warm-up Questions: Ethics GENERAL PRINCIPLES SET 13: ETHICS A physician that is employed by the local hospital is brought to the emergency department after being involved in a motor vehicle accident The drunk driver, who hit the physician and also killed her husband, is also brought to the emergency department Soon after arrival, it is discovered that the drunk driver does not have medical insurance How should each ‘patient’ be treated? Which of the ethical core principles deals with the patient’s ability to make a decision even if this decision is not recommended by the physician? What two core ethical principles are most likely to conflict with one another? A patient is diagnosed with a life-threatening condition If the physician provides the patient with all the necessary information related to the treatment options as well as the condition itself, has the principle of informed consent been met? A 62-year-old female is diagnosed with pleomorphic xanthoastrocytoma The physician explains to the patient that the recommended treatment options for this patient’s astrocytic brain tumor include radiation therapy and radiosurgery In order for the principles of informed consent to be met, must the physician also discuss the option of no therapeutic intervention? A 65-year-old patient is scheduled to have a surgical procedure and has signed all of the necessary pre-surgical documents, including an informed consent document The patient is ‘prepped’ and on the way to the operating room, at this point the patient indicates that he does not want to have the surgery What should the attending surgeon do? A 12-year-old female is brought to the emergency department after her bus was hit by a drunk driver on the way home from school The child must undergo a life-saving surgical procedure Does the physician need parental consent to perform the procedure if the parents were unable to be immediately contacted? 1 High Yield Warm-up Questions: Ethics Would parental consent be needed to perform a non-essential medical procedure in a 14-year-old female who is known to take care of herself and her younger brothers each day until her single mother arrives home from work? A 12-year-old female is brought to the emergency department after her bus was hit by a drunk driver on the way home from school The patient likely has a broken arm The physician spoke with the mother’s secretary, who indicated that the mother is on her way to the emergency department Should the physician wait to place a cast on the child’s arm? 10 A family care physician notices the appearance of a suspicious lesion on the cheek of a patient and sends a picture of the lesion to a dermatologist without the patients consent The physician sent the picture as a form of consultation Has the physician broken patient confidentiality? 11 A 35-year-old female has been seeing a psychiatrist for the past two years for the treatment of bipolar disorder The patient’s condition is well controlled and the physician believes that the patient will not harm herself or anyone else The physician receives a subpoena to appear in court for a custody hearing for the patient’s 8year-old son at the request of her ex-husband While in court, should the physician divulge the fact that his patient has bipolar disorder? 12 A psychiatrist sees his father-in-law leaving an oncologists office Later in the day, he sees the oncologist at a hospital board meeting and indicates that he saw his father-in-law leaving her office and asks if his father-inlaw is a patient at her office Can the oncologist answer this question? 13 Following a surgical procedure, it was discovered that the surgeon accidentally left a piece of gauze in the patient’s chest which caused several complications as well as another surgery to remove the gauze Could the physician be arrested for this type of error? High Yield Warm-up Questions: Ethics 14 Two physicians made errors that resulted in patient harm Physician is noted to be very rude and abrupt with patients He is described as having a ‘God complex’ by his patients Physician is noted to spend an appropriate amount of time with each patient as well as explaining things clearly Which physician is more likely to encounter a malpractice lawsuit? 15 A 62-year-old male is being treated for depression with 50 mg of desvenlafaxine daily A physician inadvertently writes a prescription for diphenhydramine 50 mg daily While on a 12 hour car ride to see his daughter a week after receiving the diphenhydramine, the patient suddenly experiences a pulmonary embolism and dies The coroner indicates that the medication error did not have anything to with the patient’s death The patient’s family files a wrongful death malpractice lawsuit Are they likely to win the case? 16 A 54-year-old patient has been coming to a physician’s office approximately once a month for the past two years because she feels that she has a different medical problem The physician appropriately assesses the patient and each time the physician determined that there was no medical evidence to support her claims When she explains the test results to the patient, the patient becomes very irate and begins using vulgar language After her last visit, it was determined that the patient has lost her medical insurance Three weeks later the patient comes back to the physician’s office complaining of severe shortness of breath What should the physician do? 17 A patient is currently receiving all of his daily nutrition from a feeding tube The patient tells the physician that he wants to have the feeding tube removed The physician explains to the patient that he needs to have the feeding tube or he will ‘starve to death’ The patient still insists that he wants the feeding tube removed If the patient is deemed to be competent by the physician, what should the physician do? 18 A 45-year-old female is brought to the emergency department by her sister after attempting to commit suicide by taking a large dose of lorazepam The physician administers flumazenil and the patient regains consciousness After several hours in the emergency department, the patient gets up and starts to leave The physician stops her and indicates that she would like to admit her The patient refuses and begins to leave again What should the physician do? These question sets are intended to be completed before viewing the High Yield course lectures Video explanations can be found on the Warm-up Questions page within the online High Yield course For further review of the topics covered in this set, refer to the following lectures: Behavioral Medicine and Ethics: • Ethics 3 ... Yield course For further review of the topics covered in this set, refer to the following lectures: Behavioral Medicine and Ethics: • Ethics 3... and asks if his father-inlaw is a patient at her office Can the oncologist answer this question? 13 Following a surgical procedure, it was discovered that the surgeon accidentally left a piece... gauze Could the physician be arrested for this type of error? High Yield Warm-up Questions: Ethics 14 Two physicians made errors that resulted in patient harm Physician is noted to be very