MTB - Ethics

Question 1

T/F: an adult with the capacity to understand his/her medical problems can refuse any therapy or test

Answer 1

TRUE
- respecting autonomy is more important than trying to do the right thing for a patient but always try to discuss things first with the patient

Question 2

beneficience

Answer 2

trying to do the right thing

Question 3

capacity vs. competence

Answer 3

capacity is determined by physicians

competence is determined by judges/courts

Question 4

when do you get a psych consult to help determine capacity?

Answer 4

when patient’s capacity to understand is not clear

- NOT for when patient is clearly competent or if patient is in a coma

Question 5

when does a minor have the “capacity” to understand their medical problems

Answer 5

not until age 18

Question 6

Emancipated minors

Answer 6

Living independently and self supporting, married or in the military

Question 7

Partial emancipation

Answer 7

sex
reproductive health
substance abuse
- exception: abortion –> 36 states have parental notification laws

Question 8

T/F: Parents can refuse lifesaving therapy for minors.

Answer 8

False.

Even in case of Jehovah’s witness - they can refuse blood for themselves but not their child. This is child abuse.

Question 9

T/F: Pregnant women can refuse life-saving therapy even when the life the fetus is at risk.

Answer 9

True.

Question 10

exception to the “privacy” rule

Answer 10

1. Patient has a transmissable disease ex. TB, HIV, gonorrhea, syphilis
2. Patient w/ psychiatric illness who may be planning to harm others

Question 11

T/F: An adult with capacity can withhold or withdraw any form of therapy.

Answer 11

True.

Question 12

Health care proxy

Answer 12

document describing the care the person desires as well as the appointment of an agent to be the decision maker should the patient lose the capacity to make decisions

Question 13

what does DNR include?

Answer 13

refusal of endotracheal intubation and CPR

Question 14

when does the ethics committee get involved in end of life care?

Answer 14

The patient is not an adult capacity.

No clearly stated wishes on part of the patient (no proxy or will)

Question 15

When else is the ethics committee the answer?

Answer 15

When the caregivers are split or in disagreement about the nature of care

Question 16

physician assisted suicide

Answer 16

providing the patient w/ means to end their life –> always wrong answer

Question 17

euthanasia

Answer 17

physician directly administers the means of ending patients life – always wrong answer

Question 18

T/F: The physician is obligated to provide treatments he feels are not beneficial if the patient insists.

Answer 18

False.

there is no obligation on part of the physician to provide care that will not work

Question 19

Do you need the consent of the father for abortion?

Answer 19

NO.

Question 20

T/F. if you are a health care worker with HIV, you have to disclose your status

Answer 20

False.

No obligation for HIV-positive workers to disclose their status.

Question 21

T/F: the physician has an obligation to accept a patient.

Answer 21

False –> the need of a person does not compel the physician to accept that person as a patient.

Question 22

T/F: Sexual relationships between physician and patient are never acceptable.

Answer 22

True in the case of psychiatry.

False in other physicians - but they must first end doctor-patient relationship.

Question 23

Can elder abuse be reported even against the will of the patient?

Answer 23

yes - depends on the patient state (i.e. if frail and vulnerable)