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Ehical Situations
Question | Answer |
---|---|
Patient is noncompliant(situation). | (appropriate response) Attempt to identify the patient's reason for noncompliance and determine his/her willingness to change; do not attempt to coerce the pt into complying or refer the pt to another physician. |
Pt desires an unnecessary procedure(situation). | Attempt to understand why the pt wants the procedure and address underlying concerns.Do not refuse to see the pt or refer him/her to another physician. |
Pt has difficulty taking medications(situation). | Provide written instructions; attempt to simplify treatment regimens. |
Family members ask for information about pt's prognosis. | Avoid discussing issues with relatives without the permission of the pt. |
A child wishes to know more about his illness. | Ask what the parents have told the child about his/her illness.Parents of a child decide what information can be relayed about the illness. |
A 17 y/o girl is pregnant and request an abortion. | Many states require parental notification or consent for minors for an abortion. Unless she is at medical risk, do not advise a pt to have an abortion regardless of her age or the condition of the fetus. |
A 15 y/o girl is pregnant and wants to keep the child.Her parents want you to tell her to give the child for adoption. | The pt retains the right to make decisions regarding her child, even if her parents disagree.Provide information to the teenager about the practical issues of caring for a baby.Discuss the options, if requested.Encourage discussion between the teenager an |
A terminally ill pt requests physician assistance in ending his life. | In the overwhelming majority of states, refuse involvement in any form of physician-assisted suicide.Physicians may, however, prescribe medically appropriate analgesics that coincidentally shorten the pt's life. |
Pt is suicidal. | Assess the seriousness of the threat; if it is serious suggest that the pt remain in the hospital voluntarily; pt can be hospitalized involuntarily if she/he refuses. |
Pt states that he finds you attractive. | Ask direct, closed-ended questions and use a chaperone if necessary.Romantic relationships with pts are never appropiate. Never say, "there can be no relationship while you are a pt", because it implies that a relationship may be possible if the individua |
A middle-aged married woman who had a mastectomy says she feels "ugly" when she undresses at night. | Find out why the pt feels this way.Do not offer falsely reassuring statements(e.g., "you still look good"). |
Pt is angry about the amount of time he spent in the waiting room. | Acknowledge the pt's anger personally.Apologize for any inconvenience.Stay away from efforts to explain the delay. |
Pt is upset with the way he was treated by another Dr. | Suggest that the pt speak directly to that physician regarding his concerns.If the problem is with a member of the office staff, tell the pt you will speak to that individual. |
A drug company offers a "referral fee" for every pt a physician enrolls in a study. | Elegible pts who may benefit from the study may be enrolled, but it is never acceptable for a physician to receive compensation from a drug company. Pts must be told about the existence of a referral fee. |
A physician orders an invasive test for the wrong pt. | No matter how serious or trivial a medical error, a physician is ethically obligated to inform a pt that a mistake has been made. |
Apt requires a treatment not covered by his insurance. | Never limit or deny care because of the expense in time or money.Discuss all treatment options with pts, even if some are not covered by their insurance companies. |