أسئلة الـ Online Cases (من السادسة للعاشرة)

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Questions and Answers

What is the likely reason for the family's behavior in the situation described?

They want to challenge the doctor's authority.

They have a strong trust in the anesthesiologist.

They cannot afford to lose their only child. (correct)

They are overly anxious about the child's surgery.

What could be a likely consequence if the family's situation is not resolved?

The child's surgery will proceed as planned.

The anesthesiologist will refuse to operate.

The family will agree without further discussion.

The operation will be canceled due to family refusal. (correct)

What is the best action the anesthesiologist should take in this scenario?

Ignore the family's request and proceed.

Reassure the family and call the surgeon. (correct)

Express frustration at the family's interruption.

Ask the family to leave the surgical area.

What is the major conflict management strategy suggested for this scenario?

Collaboration Strategy. Signup and view all the answers

What could happen if the anesthesiologist employs a dominating strategy?

The operation will not be performed, affecting the child. Signup and view all the answers

Is Scott's consent considered valid given his cognitive condition?

No, as he has been severely cognitively impaired since birth. Signup and view all the answers

Who is responsible for determining Scott's best interests?

His sister. Signup and view all the answers

What critical information must be communicated to Scott's carers?

Scott requires immediate treatment to prevent further complications. Signup and view all the answers

What should a doctor do if Scott's relatives disagree with the recommended treatment?

Follow the relatives' wishes and refuse treatment. Signup and view all the answers

Is the 29-year-old woman competent to make decisions regarding her surgery?

No, she has acute limb ischemia and is only responsive to painful stimuli. Signup and view all the answers

Does the physician need to wait for written consent before proceeding with surgery for the woman?

No, immediate action is required regardless of written consent. Signup and view all the answers

What could likely happen to the woman without immediate surgical intervention?

There is a risk of limb amputation. Signup and view all the answers

What ethical principle may be challenged in the case of Scott's treatment refusal?

Autonomy, concerning the right to make one's own decisions. Signup and view all the answers

In the case of an emergency, can a doctor operate on a patient without consent?

Yes, it's permissible in medical emergencies. Signup and view all the answers

What should the general practitioner do upon diagnosing Mohammed with tuberculosis?

Inform the school to prevent TB transmission. Signup and view all the answers

What could be a consequence if the general practitioner decides to keep Mohammed's tuberculosis diagnosis secret?

Increased risk of TB transmission leading to an epidemic. Signup and view all the answers

Why is it considered professional to disclose a patient's secret in certain conditions?

Public health is prioritized in cases of infectious diseases. Signup and view all the answers

Which of the following is NOT a condition where a doctor should disclose patient secrets?

For minor illnesses like the common cold. Signup and view all the answers

What is the primary duty of a doctor when faced with a patient who has a contagious disease but wants to keep it confidential?

Divulge the patient's condition to prevent public risk. Signup and view all the answers

In the scenario with the female patient suffering from schizophrenia, what did her husband request from the doctor?

A medical certificate to present to the National Health Service. Signup and view all the answers

What should a doctor consider when asked to provide medical information for someone else's use?

The legal implications of sharing confidential information. Signup and view all the answers

What potential outcome arises if the anesthesiologist adopts a dominating strategy in this scenario?

The family may lose trust in the medical team. Signup and view all the answers

From an ethical standpoint, what was the psychiatrist's error in handling the husband's request for information?

The psychiatrist breached patient confidentiality without consent. Signup and view all the answers

What is the primary reason for the family’s anxiety regarding their child's surgery?

Fear of losing their only child amidst uncertainty. Signup and view all the answers

In conflict management, what is the impact of using the collaboration strategy in the described medical scenario?

It results in mutual satisfaction and a cooperative relationship. Signup and view all the answers

What might be a significant consequence of not addressing the family's concerns prior to surgery?

The planned surgery will likely be canceled or delayed. Signup and view all the answers

In which situation is it justified for a doctor to breach patient confidentiality?

When the patient has a highly infectious disease Signup and view all the answers

What could be a legal implication for the general practitioner if they keep Mohammed's tuberculosis diagnosis a secret?

They may be liable for medical malpractice Signup and view all the answers

What is the primary reason for the general practitioner to inform the school about Mohammed's condition?

To prevent an outbreak among students and staff Signup and view all the answers

What is a situation where patient confidentiality must be breached?

In cases of serious mental health issues Signup and view all the answers

What justification does a doctor have to disclose a patient's information without consent?

To protect public health Signup and view all the answers

What could be a consequence of disclosing a teacher's tuberculosis diagnosis without consent?

It could lead to the prevention of a potential outbreak Signup and view all the answers

In which circumstance can a doctor handle a patient's case without waiting for the patient's consent?

When the patient is unconscious due to an accident Signup and view all the answers

What action should a doctor take if a patient insists on confidentiality regarding a contagious disease?

Inform the patient about the legal implications of confidentiality Signup and view all the answers

What is the primary issue regarding Scott's ability to provide consent for treatment?

He has been severely cognitively impaired since birth. Signup and view all the answers

In this scenario, who is predominantly responsible for making decisions in Scott’s best interests?

His sister Signup and view all the answers

What urgent action should be taken regarding the 29-year-old woman with limb ischemia?

Initiate immediate surgical intervention without consent. Signup and view all the answers

What type of consent is typically required before performing surgery on a patient?

No consent is needed in emergencies. Signup and view all the answers

What should the medical team ensure when notifying Scott's carers about his condition?

That they communicate the inevitability of his death if untreated. Signup and view all the answers

Which factor might complicate surgical consent for the woman after her car accident?

Her responsiveness only to painful stimuli. Signup and view all the answers

What happens if Scott's family members refuse recommended treatment?

The doctor must respect their refusal and refrain from any treatment. Signup and view all the answers

What critical decision-making aspect was exhibited by the physician regarding the informed consent of the car accident victim?

The physician prioritized her critical condition over consent. Signup and view all the answers

Study Notes

Patient with Prostatic Hypertrophy

Scott, 63, has severe cognitive impairment, and acute urinary retention.
He needs a catheter and transurethral resection of the prostate.
He is uncomfortable with needles, and has a good relationship with carers and sister.
His sister will make the decisions regarding his care.
Recurrent retention and potentially renal failure are serious risks without treatment.
Informed consent is invalid due to his cognitive impairment.
Carers should be informed about the necessary procedures, including catheterization and surgery.
If relatives disagree with the physician's recommendations the physician is obliged not to provide treatment they reject.

Patient with Medical Emergency

A 29-year-old Egyptian woman was severely injured in a car accident; she has limb ischemia due to an arterial injury.
She responded to painful stimuli, but was not competent to agree to surgery.
The doctor needs to act swiftly to prevent potential limb amputation.
The doctor should not wait for a written consent.
The doctor may act immediately in the patient's best interests because of the emergency nature of the case and absence of relatives.
Relatives can be contacted if consciousness returns, and informed consent possible.

Teacher with Tuberculosis

A teacher with tuberculosis refuses to tell his school of his condition.
He has fever, cough, night sweats and was diagnosed with tuberculosis.
If kept secret, the disease could potentially spread.
The general practitioner should inform the school of the teacher's condition to avoid the risk of transmission.
Failing to disclose the condition could lead to an epidemic.
It is not professional to keep such a serious condition a secret, as it is important to inform the public to avoid an epidemic, and for the teacher's safety & well-being.

Similar Conditions Requiring Disclosure

Cases of Infectious Diseases
Mentally Ill patients
Conditions that prohibit certain jobs (e.g., uncontrolled hypertension in drivers, or gonorrhea amongst swimmers.)

Female with Schizophrenia

A female patient with long term schizophrenia, is under treatment.
Her husband requests a medical certificate for presentation to the National Health Service.
The certificate is wrongfully used for a court order to control the patient's funds.
The patient's lawyer filed a professional misconduct claim.
Confidentiality was breached by the doctor divulging the patient's private information without the patient's agreement.
The husband is not authorized to receive her medical information
Doctor action was wrong, and unethical and not excusable.

Child with Cancer

A child with a malignant tumour requires surgery.
Parents are insistent on speaking to the surgeon.
Surgery needs immediate attention and is likely to fail if the surgeon is unavailable.
The child's family only wants to speak to the surgeon before continuing.
The likely reason is that the family value their child and does not want to lose him.
The best action is for the anaesthesiologist to reassure the family and call for the surgeon.
Without intervention, surgery may not go ahead and the child be harmed.
The best conflict management strategy is Collaboration.
If the anaesthesiologist uses domination, the operation will not be performed and the child will lose out.

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