Medical Ethics

21. A 16-year-old pregnant woman ingested alcohol and illicit drugs (e.g., cocaine, crack) which are harmful to the fetus. What should a physician do? (Important)
    Answer: The physician should be careful in reporting this case because the pregnant woman may not come back for prenatal care, which is important for both the mother and the fetus. However, if the baby’s urine toxicology test is positive for illicit drugs, case should be reported to CWA (Child Welfare Agency). CWA suggests separate custody, for the child.
    
    
22. A physician wants to study a group of children aging from 10-12 year old. Physician already got the consent from the parents. However, he didn’t discuss the study with the children. A child refused to participate. Should the physician force the child to participate? (Important)
    Answer: no, because a child can refuse to participate, in a research study.
    
    
23. A child needs hernia repair. His mother is a 40-year-old schizophrenic patient. Surgeon discussed the procedure with the mother who understood the procedure. Can the mother give consent? (Important)
    Answer: yes. If a psychiatric patient understands the procedure, he or she can give the consent.
    
    
24. A newborn needs a complicated cardiac surgical procedure. His mother is a schizophrenic patient. Cardiologist explained the procedure to the mother who did not understand the procedure. Who can give the consent on behalf of the patient? (Important)
    Answer: the patient’s relative can give the consent. If nobody is available to give the consent, court order should be obtained. If a psychiatric patient does not understand the procedure, he or she cannot give the consent. Cardiothoracic surgeon should obtain the consent.
    
    
25. A 25-year-old woman developed postpartum psychosis. The newborn developed cyanosis due to congenital heart disease. The newborn needs cardiac surgery. Surgeon discussed the procedure with the mother. She understood the procedure. Can she give the consent? (Important)
    Answer: yes, because she understood the procedure.
    
    
26. A newborn is diagnosed with either trisomy 18 or 13 with TE (tracheoesophageal) fistula which requires surgery. Mother requested surgeon to repair the TE-fistula. What should a surgeon do? (Important)
    Answer: surgeon should refuse to do the reparative surgery because these conditions (trisomy 18 or 13) are nonviable. If the patient survives, surgeon can put a gastrostomy feeding tube for nutrition. However, please remember that a patient with trisomy 21 (Down syndrome) with TE fistula should be operated on.
    
    
27. A 17-year-old terminally ill patient wanted to die. He has been suffering from constant pain. He asked the physician to give him some medication which can expedite his death. What should a physician do? (Very important)
    Answer: physician cannot give any medication which will expedite the death. However, physician can prescribe medication to minimize the pain. The dose should be appropriate. Physician-assisted suicide is illegal everywhere .
    
    
28. A 17-year-old boy came to a doctor for recurrent UTIs and dysuria. The diagnosis of (ESRD) end stage renal disease was made after appropriate investigations. Should the doctor tell the bad news to the patient? (Important)
    Answer: yes, physician must tell the truth to the patient.
    
    
29. Can a medical student introduce himself or herself as a ‘doctor’ to the patient? (Important)
    Answer: no. A patient can refuse a medical student from performing any procedure. However, medical students are allowed to perform a procedure under appropriate supervision if the patient agrees to that.
    
    
30. A 18-year-old man is diagnosed to have suspected bacterial meningitis. He refused therapy and returned to the college dormitory. What should a physician do in this situation? (Very important)
    Answer: physician should report to the college authority and recommend that the suspected individual should be isolated during the course of his illness.