Medical Ethics

1. A mother refused immunization for her 2-month-old son. The Social worker spoke to the mother. (Important for Board examination)
   Next Step in management: immunization should not be given.
   
   
2. A mother refused surgery for suspected appendicitis for her 6-year-old daughter. The social worker spoke to the mother.(Important for Board examination)
   Next Step in management: surgical removal of the appendix should be performed for the benefit of the child.
   
   
3. A 16-year-old boy was diagnosed with osteosarcoma of the right thigh. The surgeon recommended amputation. The boy refused amputation. He is doing very well otherwise. He is aware that death is certain without surgery. (Important)
   Next Step in management: amputation should not be performed. Adolescent patients or adults who are competent in making decisions have an absolute right to determine what shall be done with their own bodies. However, most pediatric patients are not competent to make their own decisions. Please remember, children (15 years or older) are usually able to give a genuinely informed consent. Therefore physicians may respond to their requests, except in a case of irreversible sterilization.
   
   
4. A 17-year-old girl is a Jehovah’s witness. She refused a lifesaving blood transfusion. She is aware of the consequences. She spoke to the social worker. (Important)
   Next Step in management: blood transfusion should not be given because she is competent to make the decision.
   
   
5. A 5-year-old girl is a Jehovah’s witness. She requires emergency blood transfusion. Her mother refused blood transfusion. A social worker along with two physicians, spoke to the mother (Important)
   Next Step in management: blood transfusion should be given because the patient is not competent. Mother cannot refuse her daughter’s treatment.
   
   
6. A 2-year-old boy was brought to the ER by his parents for an injury. Physician made the diagnosis of child abuse. There are three other children living in the same household. Both parents confessed to child abuse but requested the physician to keep it confidential. Social worker was involved. (Important)
   Next Step in management: the case should be reported to Child Welfare Agency (CWA). All children should be removed from the parents.
   
   
7. A 15-year-old boy with STD (sexually transmitted disease) came to see a physician. He asked the physician not to tell his parents. (Very important)
   Next Step in management: the physician should treat the patient and notify the appropriate health authority, but should not tell his parents.
   
   
8. A 16-year-old boy wants to use a condom. He comes to the clinic for free samples. He requested the physician, however, not to tell his parents. (Important)
   Next Step in management: condom should be given and physician should not tell his parents.
   
   
9. A 17-year-old male patient is recently diagnosed with HIV. He lives with his girlfriend but is promiscuous. He requested the physician not to tell his girlfriend. He lost his job recently. Social worker spoke to the patient. (Very important)
   Next Step in management: physician should notify the appropriate authority (e.g., department of health) for the safety of other specific persons who are engaged in unsafe sexual practices. The physician, however, should ask the patient to divulge the diagnosis to his girlfriend and other sexual partners.
   
   
10. A very small premature infant was born in the delivery room by NSVD (normal spontaneous vaginal delivery). The attending physician decided not to resuscitate the newborn. Physician spoke to the mother. Mother started to cry. Newborn expired after 30 minutes. Is the physician liable for newborn’s death?
    Answer: No.